# ShockRef vs UPDATE SIM

The clearest difference is price: ShockRef at Free against UPDATE SIM's $49.99. UPDATE SIM's advantage is update cadence (daily vs every 4 days) and iOS requirement (16.0 vs 26.0). On ads, in-app purchases and device support there is nothing between them.

ShockRef is free to download; UPDATE SIM costs $49.99 up front. Neither carries in-app purchases, so what you see is what you pay.

ShockRef ships an update every 4 days, UPDATE SIM daily. The most recent releases landed on October 10, 2026 and September 28, 2026 respectively.

## The numbers

| Metric | ShockRef | UPDATE SIM |
| --- | --- | --- |
| Price | **Free** | $49.99 |
| Rating | **[5.0 (3 ratings)](https://appshunter.io/ios/app/shockref/id6793122630/reviews)** | — |
| Number of ratings | **3** | — |
| In-app purchases | No | No |
| Ads | No | No |
| Update frequency | Every 4 days | **Daily** |
| Monetization | Free | — |
| Size | 15 MB | 7 MB |
| Requires iOS | 26.0 | **16.0** |
| Devices | iPhone, iPad | **iPhone, iPad, Apple Watch** |
| Age rating | 17+ | 17+ |
| Developer | [Rishi Kumar](https://appshunter.io/developer/1434016052) | [Osvaldo Campos Carvajal](https://appshunter.io/developer/6794471588) |

## What reviewers say

### 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


### UPDATE SIM

[App page](https://appshunter.io/ios/app/update-sim-ecg-simulator/id6794471586)

**Features:** macOS Compatibility, Apple Watch app, Vision Pro support

**In-app purchases:** none


## Frequently asked questions

### Is ShockRef free?

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

### Is UPDATE SIM free?

UPDATE SIM costs $49.99, with no in-app purchases.

### Do ShockRef or UPDATE SIM have ads?

Neither ShockRef nor UPDATE SIM shows ads.

### Which is updated more often, ShockRef or UPDATE SIM?

ShockRef ships an update every 4 days, and UPDATE SIM daily. Most recently, ShockRef was updated on October 10, 2026 and UPDATE SIM on September 28, 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.*