The ASRA Coags App is a valuable digital tool designed for anesthesia providers to assist in managing anticoagulation and regional anesthesia. Developed by the American Society of Regional Anesthesia and Pain Medicine (ASRA), this application offers up-to-date guidelines on the perioperative management of anticoagulants and antiplatelet agents. Given the increasing prevalence of patients on chronic anticoagulation therapy, this app serves as an essential resource for optimizing patient safety and preventing perioperative bleeding or thrombotic complications 1.
The ASRA Coags App provides a user-friendly interface that allows anesthesia providers to quickly access evidence-based recommendations. The app includes a comprehensive database of commonly used anticoagulants and antiplatelet medications, detailing their pharmacokinetics, recommended hold times before regional anesthesia, and the appropriate timing for resumption post-procedure. Additionally, it offers guidance on neuraxial procedures, peripheral nerve blocks, and emergency reversal strategies for patients on anticoagulation therapy.
One of the standout features of the app is its interactive functionality, enabling users to input patient-specific factors such as renal function, medication dosage, and procedural type. The app then generates tailored recommendations to assist clinicians in making informed decisions regarding perioperative anticoagulation management. This feature enhances efficiency by reducing the need for manual guideline searches and minimizes the risk of errors associated with anticoagulation management 1–3.
The app plays a crucial role in enhancing patient safety by providing standardized, evidence-based recommendations. In regional anesthesia, the timing of anticoagulant discontinuation and resumption is critical to minimizing the risk of spinal hematomas and other complications. By offering real-time access to guidelines, the app supports anesthesia providers in making safer clinical decisions, ultimately improving patient outcomes.
Moreover, the ASRA Coags App streamlines communication between anesthesia providers, surgeons, and other perioperative team members. By having a centralized and reliable reference, healthcare professionals can coordinate better, ensuring that anticoagulation protocols align with both surgical and anesthetic needs. The app also helps prevent unnecessary cancellations or delays in surgery by providing clear, structured recommendations on anticoagulant management 4–7.
Despite its numerous advantages, the ASRA Coags App has some limitations. While it provides robust guidance, clinical judgment remains essential, as each patient’s case may present unique complexities not fully covered by the app. Additionally, institutional policies and evolving research may lead to variations in practice, necessitating periodic updates to the app to maintain its relevance and accuracy. Furthermore, while mobile applications are convenient, some providers may prefer printed guidelines or hospital-specific protocols 4,8.
The ASRA Coags App is an invaluable tool for anesthesia providers, offering quick access to evidence-based recommendations for managing anticoagulation in the perioperative period. While clinical judgment and institutional protocols may remain essential, integrating digital tools like the ASRA Coags App into perioperative workflows may significantly enhance patient care and safety in modern anesthesia practice.
References
1. Apps. ASRA Pain Medicine https://asra.com/guidelines-articles/asra-apps.
2. ASRA Pain Medicine Home. ASRA Pain Medicine https://asra.com.
3. Popular ASRA Coags app helps physicians protect patients taking anticoagulants. News-Medical https://www.news-medical.net/news/20180416/Popular-ASRA-Coags-app-helps-physicians-protect-patients-taking-anticoagulants.aspx (2018).
4. Gupta, R. K. & McEvoy, M. D. Initial Experience of the American Society of Regional Anesthesia and Pain Medicine Coags Regional Smartphone Application: A Novel Report of Global Distribution and Clinical Usage of an Electronic Decision Support Tool to Enhance Guideline Use. Reg Anesth Pain Med 41, 334–338 (2016). DOI: 10.1097/AAP.0000000000000391
5. Praus, F. et al. Smartphone Apps for Managing Antithrombotic Therapy: Scoping Literature Review. JMIR Cardio 6, e29481 (2022). DOI: 10.2196/29481
6. Pan, S. & Rong, L. Q. Mobile Applications in Clinical and Perioperative Care for Anesthesia: Narrative Review. J Med Internet Res 23, e25115 (2021). DOI: 10.2196/25115
7. Gupta, R. K., Horlocker, T. & McEvoy, M. D. Initiative to accelerate guideline distribution using the smartphone app ASRA Coags V.2.0. Reg Anesth Pain Med 46, 354–355 (2021). DOI: 10.1136/rapm-2020-101921
8. Weisman, R. S. & Gebhard, R. E. What’s Up With the App?: Inconsistencies Within the ASRA Coags Regional Smartphone App Leave Practitioners Guessing. Reg Anesth Pain Med 42, 117 (2017). DOI: 10.1097/AAP.0000000000000500
