The electronic Pediatric Emergency Ruler - A digital alternative to the BroselowTape

Main Article Content

Alexander R Schmidt Markus Weiss Karl-Philipp Buehler Joerg Thomas Stefan Mueller Christian Peter Both

Abstract

Study objective: The Broselow® tape (BT) is a pediatric emergency tape (PET) supporting medical teams during pediatric emergencies in estimating body weight, recommending drug dosage and medical equipment. Publications have reported the risk of incorrect use and low accuracy. A recently published digital algorithm for length-based body weight estimation showed higher accuracy for weight estimation. A prototype for an electronic Pediatric Emergency Ruler (ePER) utilizing this algorithm was developed for further testing. The aim of this study was to compare the BT with the ePER in terms of time and correctness of identifying medical information required during pediatric emergency treatment.


Methods: Voluntary participants were randomly assigned to use the BT or the ePER in a simulated low-fidelity pediatric emergency manikin scenario and instructed to identify four parameters. Outcomes were time required for identification of all parameters, correct determination of length-based weight and erroneous reading of parameters for the selected weight category. Data are mean or percent. T-test for statistical significance (p < 0.05) and standardized mean difference (SMD > 0.8) were calculated.


Results: Identifying medical information was significantly faster with the ePER than with the BT (24.5 vs 36.7 sec, p<0.001; SMD 1.53). Both devices were used correctly in 77.8% of the cases. Overall erroneous readings occurred in 1.9%.


Conclusion: The ePER represents a modern and comprehensive solution to support medical staff during pediatric emergencies. This digital solution could be considered as an alternative to the BT.

Keywords: pediatric, body weight and measures, device development, emergency treatment, resuscitation

Article Details

How to Cite
SCHMIDT, Alexander R et al. The electronic Pediatric Emergency Ruler - A digital alternative to the BroselowTape. Medical Research Archives, [S.l.], v. 8, n. 5, may 2020. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2089>. Date accessed: 25 apr. 2024. doi: https://doi.org/10.18103/mra.v8i5.2089.
Section
Research Articles

References

Heyming T, Bosson N, Kurobe A, et al. Accuracy of paramedic Broselow tape use in the prehospital setting. Prehosp Emerg Care. 2012;16:374-80.
2. Larose G, Levy A, Bailey B, et al. Estimating the Weight of Children During Simulated Emergency Situations Using the Broselow Tape: Are We Underestimating the Risks of Errors? Pediatr Emerg Care. 2018.
3. Kaji AH, Gausche-Hill M, Conrad H, et al. Emergency medical services system changes reduce pediatric epinephrine dosing errors in the prehospital setting. Pediatrics. 2006;118:1493-500.
4. Hoyle JD, Davis AT, Putman KK, et al. Medication Dosing Errors in Pediatric Patients Treated by Emergency Medical Services. Prehosp Emerg Care. 2012;16:59-66.
5. Lammers R, Byrwa M, Fales W. Root Causes of Errors in a Simulated Prehospital Pediatric Emergency. Acad Emerg Med. 2012;19:37-47.
6. Schmidt AR, Hass T, Buehler KP, et al. Comparison of Broselow® tape and pediatric emergency ruler. Accuracy of weight estimation. Notfall Rettungsmed. 2015;19:129-135.
7. Both CP, Schmitz A, Buehler KP, et al. How Accurate Are Pediatric Emergency Tapes? A Comparison of 4 Emergency Tapes With Different Length-Based Weight Categoriza-tion. Pediatr Emerg Care. 2017.
8. Wells M, Goldstein LN, Bentley A. The accuracy of emergency weight estimation systems in children-a systematic review and meta-analysis. Int J Emerg Med. 2017;10:29.
9. Wells M, Goldstein LN, Bentley A, et al. The accuracy of the Broselow tape as a weight estimation tool and a drug-dosing guide - A systematic review and meta-analysis. Resuscitation. 2017;121:9-33.
10. Young KD, Korotzer NC. Weight Estimation Methods in Children: A Systematic Review. Ann Emerg Med. 2016;68:441-451.
11. Both CP, Schmitz A, Buehler KP, et al. Comparison of a paediatric emergency ruler with a digital algorithm for weight and age estimation. Acta Anaesthesiol Scand. 2017;61:1122-1132.
12. Lubitz DS, Seidel JS, Chamedies L, et al. A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group. Ann Emerg Med. 1988;17:576-81.
13. Hofer CK, Ganter M, Tucci M, et al. How reliable is length-based determination of body weight and tracheal tube size in the paediatric age group? The Broselow tape reconsidered. Br J Anaesth. 2002;88:283-5.
14. Meguerdichian MJ, Clapper TC. The Broselow tape as an effective medication dosing instrument: a review of the literature. J Pediatr Nurs. 2012;27:416-20.
15. Milne WK, Yasin A, Knight J, et al. Ontario children have outgrown the Broselow tape. CJEM. 2012;14:25-30.
16. Black K, Barnett P, Wolfe R, et al. Are methods used to estimate weight in children accurate? Emerg Med. 2002;14:160-5.
17. Krieser D, Nguyen K, Kerr D, et al. Parental weight estimation of their child's weight is more accurate than other weight estimation methods for determining children's weight in an emergency department? Emerg Med J. 2007;24:756-9.
18. So TY, Farrington E, Absher RK. Evaluation of the accuracy of different methods used to estimate weights in the pediatric population. Pediatrics. 2009;123:1045-51.
19. Jung JY, Kwak YH, Kim DK et al.An assessment of the accuracy of a novel weight estimation device for children. EMJ. 2017;34:163-9.