Both Christian P, Schmitz Achim, Buehler Philipp K, Weiss Markus, Schmidt Alexander R
From the Department of Anaesthesia and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
Pediatr Emerg Care. 2020 Mar;36(3):e151-e155. doi: 10.1097/PEC.0000000000001212.
Pediatric emergency tapes have been developed to support paramedics and emergency physicians when dosing drugs and selecting medical equipment in pediatric emergency situations. The aim of this study was to compare the accuracy of 4 pediatric emergency tapes to correctly estimate patient's weight based on a large population of patients.
Patients undergoing general anesthesia between January 2012 and March 2015 with documented age, sex, body weight, and length were identified from the electronic anesthesia patient data management system of the Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland. Weight estimation by means of the Broselow-Tape, the Pädiatrisches Notfalllineal, the Paulino System, and the Kinder-Sicher were compared with true patient's weight. Percentages of estimated body weight within a ±10% and ±20% interval were calculated. Data are median (interquartile range) or count (percent); statistical calculations were done with McNemar and Bonferroni correction.
A total of 3307 patients were identified with complete data sets, 1930 (58.4%) were male, median age was 4.1 years (1.1-8.2 years), median length 101.0 cm (74.0-126.0 cm) and median patient weight 15.8 kg (9.2-25.0 kg). The proportion weight estimation within the ±10% and the ±20% interval was the highest in the Broselow-Tape with 54.0% and 81.5% (P < 0.001 and P = 0.003), followed by the Pädiatrisches Notfalllineal (50.5% and 79.8%), Paulino System (49.9% and 78.0%) and Kinder-Sicher (48.2% and 77.5%).
The overall accuracy of all 4 emergency tapes tested is poor and including a larger number of weight categories does not necessarily increase accuracy. Other strategies have to be developed to improve weight estimation in pediatric emergency situations.
儿科急救卷尺已被开发出来，用于在儿科紧急情况下帮助护理人员和急诊医生确定药物剂量及选择医疗设备。本研究的目的是基于大量患者群体，比较4种儿科急救卷尺正确估算患者体重的准确性。
从瑞士苏黎世大学儿童医院麻醉科的电子麻醉患者数据管理系统中，识别出2012年1月至2015年3月期间接受全身麻醉且有年龄、性别、体重和身长记录的患者。将通过布罗泽洛卷尺（Broselow-Tape）、儿科急救卷尺（Pädiatrisches Notfalllineal）、保利诺系统（Paulino System）和儿童安全卷尺（Kinder-Sicher）估算的体重与患者实际体重进行比较。计算估计体重在±10%和±20%区间内的百分比。数据为中位数（四分位间距）或计数（百分比）；采用麦克尼马尔检验和邦费罗尼校正进行统计计算。
共识别出3307例具有完整数据集的患者，其中1930例（58.4%）为男性，中位年龄为4.1岁（1.1 - 8.2岁），中位身长101.0厘米（74.0 - 126.0厘米）以及中位患者体重15.8千克（9.2 - 25.0千克）。布罗泽洛卷尺在±10%和±20%区间内的体重估计比例最高，分别为54.0%和81.5%（P < 0.001和P = 0.003），其次是儿科急救卷尺（50.5%和79.8%）、保利诺系统（49.9%和78.0%）以及儿童安全卷尺（48.2%和77.5%）。
所测试的所有4种急救卷尺的总体准确性较差，增加更多体重类别并不一定会提高准确性。必须制定其他策略来改善儿科紧急情况下的体重估计。
