When the Wi‑Fi Drops: An ER Team's Reliance on Online Dosage Tools
A real-world example of Google effect in action
Context
A busy metropolitan emergency department had adopted several online calculators and up‑to‑date clinical summaries to reduce errors and speed care. Staff were encouraged to use these tools rather than memorizing rare medication dosages or infusion rates.
Situation
During a scheduled network maintenance a weekday afternoon, the hospital's Wi‑Fi and access to external clinical calculators went offline for about 90 minutes. An incoming patient required a weight‑based bolus of an uncommon antiarrhythmic used infrequently in the unit.
The bias in action
Because clinicians habitually looked up the drug's dosing online, several team members could not recall the correct bolus amount from memory and deferred to a colleague who normally checks the calculator. The team attempted to reconstruct the dose by remembering where they'd find it rather than the numeric value, resulting in uncertainty and repeated double‑checks. The delay and inability to recall the figure stemmed from the Google effect: information had been encoded as 'where to find' rather than the content itself.
Outcome
Clinicians paused treatment while contacting pharmacy and searching archived paper protocols; the medication was ultimately given at the correct dose but 18 minutes later than ideal for the condition. The event was logged as a near‑miss; there were no lasting patient harms, but the delay prolonged the patient's symptomatic arrhythmia and extended ED stay.