The electronic Pediatric Emergency Ruler - A digital alternative to the BroselowTape
Main Article Content
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.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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.