Evaluation of 2 novel devices for calculation of fluid requirements in pediatric burns.

OBJECTIVES

The Parkland formula for maintenance and resuscitation fluid requirements in the first 24 hours after pediatric burns is widely used, but calculation errors frequently occur. Two different novel aids to calculation, a dedicated electronic device and a mechanical disc calculator, are described and compared with the conventional method of calculation (pen and paper, assisted by a general purpose calculator).

METHODS

In a blinded randomized volunteer study, 21 participants performed a total of 189 calculations using simulated patient data to compare the accuracy and speed of 3 different methods for calculating resuscitation fluid requirements based on the pediatric Parkland formula. Bespoke software generated the simulated patient data and recorded accuracy and speed of all participant responses.

RESULTS

Sixty-five percent of calculations with the electronic device, 35% using the disc and 44% using the pen/paper methods were within ±5% of the correct value and considered "correct" for clinical purposes. The method used strongly affected the tendency to make errors (logistic regression). With thresholds of error magnitude classed as very small (>5%), small (>25%), medium (>50%) and large (>100%) of the correct value respectively, the electronic method produced fewer errors than both disc and pen/paper methods at all error thresholds. Disc produced more errors than pen/paper at the greater than 5% threshold but fewer at the greater than 25%, greater than 50%, and greater than 100% thresholds.

CONCLUSIONS

Both novel devices provide safer and faster alternatives to conventional methods for calculation of fluid requirements in pediatric burns.