# ECHO On vs ShockRef

The clearest difference is ratings volume: ECHO On at 14 against ShockRef's 3. ECHO On also leads on iOS requirement (15.6 vs 26.0). On price, rating, update cadence and ads there is nothing between them.

Both are free to download. Neither carries in-app purchases, so what you see is what you pay.

On the App Store both sit at effectively the same score — 4.9 for ECHO On against 5.0 for ShockRef. Both are backed by a comparable volume of ratings — 14 and 3 respectively.

ECHO On ships an update weekly, ShockRef every 4 days. The most recent releases landed on October 13, 2026 and October 10, 2026 respectively.

## The numbers

| Metric | ECHO On | ShockRef |
| --- | --- | --- |
| Price | Free | Free |
| Rating | [4.9 (14 ratings)](https://appshunter.io/ios/app/echo-on/id1519707786/reviews) | **[5.0 (3 ratings)](https://appshunter.io/ios/app/shockref/id6793122630/reviews)** |
| Number of ratings | **14** | 3 |
| Positive reviews | 100.0% of reviews | — |
| In-app purchases | No | No |
| Ads | No | No |
| Update frequency | Weekly | **Every 4 days** |
| Monetization | Free | Free |
| Size | 414 MB | 15 MB |
| Requires iOS | **15.6** | 26.0 |
| Devices | **iPhone, iPad, iPod** | iPhone, iPad |
| Age rating | 12+ | 17+ |
| Developer | [Robert Arrigo](https://appshunter.io/developer/1519707788) | [Rishi Kumar](https://appshunter.io/developer/1434016052) |

## What reviewers say

### ECHO On

[App page](https://appshunter.io/ios/app/echo-on/id1519707786)

This medical education app helps users learn Transesophageal Echocardiography with a question bank, cognitive aid, case log, and reference library. It provides guidance on performing and interpreting a standard 28-view exam, including anatomy, function, and Doppler interrogations.

**Highlights:** Transesophageal Echocardiography education, Enlarging question bank, Rescue TEE cognitive aid, Case Log system, Perioperative Quick Reference library, Offline echo loops, Pathology, technique, and normal loop examples

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases:** none


### ShockRef

[App page](https://appshunter.io/ios/app/shockref/id6793122630)

A clinical reference for managing shock and hemodynamics, offering insights into bedside physiology, resuscitation, and mechanical circulatory support. It includes practical calculators and drug references for critical care professionals and students.

**Highlights:** Shock phenotyping, Resuscitation workflows, Vasoactive drug references, Mechanical circulatory support troubleshooting, Physiology-based critical care, Practical calculators

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases:** none


## Frequently asked questions

### Is ECHO On free?

ECHO On is free to download, with no in-app purchases.

### Is ShockRef free?

ShockRef is free to download, with no in-app purchases.

### Which has better reviews, ECHO On or ShockRef?

ShockRef is rated higher. ECHO On averages 4.9 out of 5 from 14 ratings, while ShockRef averages 5.0 from 3 ratings.

### Do ECHO On or ShockRef have ads?

Neither ECHO On nor ShockRef shows ads.

### Which is updated more often, ECHO On or ShockRef?

ECHO On ships an update weekly, and ShockRef every 4 days. Most recently, ECHO On was updated on October 13, 2026 and ShockRef on October 10, 2026.

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*Compared by [AppsHunter](https://appshunter.io/) from daily US App Store data. Review summaries are generated from verbatim App Store reviews.*