Weighing the Pediatric Patient During Trauma Resuscitation and Its Concordance With Estimated Weight Using Broselow Luten Emergency Tape
ABSTRACT Obtaining an accurate weight is crucial during pediatric trauma/medical resuscitation. Currently, length-based weight estimations are used. Study objective was to assess feasibility of obtaining actual weights of children during trauma resuscitation and study its concordance with length-based estimated weight using the Broselow Pediatric Emergency Tape.
Pediatric trauma patients 0 to 14 years old presenting to a tertiary care pediatric trauma center between November 2008 and October 2009 were enrolled prospectively. Length-based weight estimation was done on patient arrival using the Broselow tape; in addition, an actual patient weight was recorded using the trauma stretcher integrated weighing scale.
Two hundred thirty-one patients were eligible and enrolled. Weights were recorded in 145 children (63.2%). In 27 patients (18.6%) whose body length exceeded Broselow tape range, weight was measured using stretcher scale only. The remaining 118 patients (mean age, 5.0 [SE ± 0.3] years; 67% male) were used for correlation analysis. There was good correlation (Pearson correlation coefficient, r = 0.86) between estimated weight and measured weight. However, Bland-Altman analysis showed mean bias +2.6 kg (95% confidence interval [CI], 1.6-3.6 kg); lower/upper limits of agreement were -8.3 kg (CI, -10.0 to -6.6 kg) and 13.5 kg (CI, 11.7-15.2 kg).
It is possible to obtain an actual patient weight during pediatric trauma resuscitation. Length-based estimated weight using Broselow tape underestimated weight by 2.6 kg; the mean error was greatest in the highest weight category.
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ABSTRACT: Introduction During paediatric resuscitation it is essential to be able to estimate the child's weight as it determines drug doses and equipment sizes. Age and length based estimations exist, with age based estimations being especially useful in the preparation phase and the length based Broselow tape having weight based drug doses and equipment already assigned via a colour code system. The aim of this study was to compare the actual recorded weights of Australian children to the predicted weights using the original and updated APLS, Luscombe and Owens and Best Guess formulae and the Broselow tape. Method A retrospective observational study of children attending an Australian tertiary children's hospital. Results From 49565 patients extracted from the database, 37 114 children with age and weight and 37 091 children with age and height recorded were included in the analysis. Best Guess was the most accurate, with the smallest overall mean difference 0.86kg. For <1 year olds, Broselow tape was the most accurate (mean difference -0.43kg), Best Guess was the most accurate for ages 1-5 years and 11-14 years (mean difference 0.27kg and 0.20kg respectively), and the updated APLS formula was the most accurate for 6-10 year olds (mean difference 0.42kg). The Broselow tape was able to only classify 48.9% of children into the correct weight colour band. Conclusions For an age based weight estimation, in infants less than one year the new APLS formula is the most accurate and over one year the Best Guess formulae should be used.Resuscitation 12/2013; DOI:10.1016/j.resuscitation.2013.11.024 · 3.96 Impact Factor
Journal of Emergency Nursing 05/2013; 39(4). DOI:10.1016/j.jen.2013.03.017 · 1.13 Impact Factor
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ABSTRACT: Objective. Pediatric obesity affects more than 16% of American children and is associated with worse outcomes in hospitalized patients. A systematic literature review was performed to identify studies of adverse care events affecting obese pediatric patients in the emergency room, operating room, or inpatient wards. Evidence Review. We systematically searched Medline for articles published from 1970 to 2013 regarding obesity and patient safety events in pediatric acute care settings. We determined the study design, number of patients studied, definition and prevalence of obesity, the relevant acute care setting, the specific association with obesity addressed, and the results of each study. Results and Conclusion. Thirty-four studies documented both procedural complications and issues with general hospital care. Most were retrospective and focused on surgery or anesthesia. Obese patients may have increased risk for a variety of adverse events. Further study could improve institutional patient safety guidelines to enhance care for obese children.Clinical Pediatrics 05/2014; 53(10). DOI:10.1177/0009922814533406 · 1.26 Impact Factor