Validation of two pediatric resuscitation tapes.

OBJECTIVE

This study aims to compare the actual weights of Filipino children with their estimated weights obtained from the Broselow tape and the Pediatric Advanced Weight Prediction in the Emergency Room eXtra Length-Mid-arm Circumference (PAWPER XL-MAC) tape.

METHODS

A prospective, observational, cross-sectional study conducted among Filipino children admitted at the Pediatric Emergency Department (ED) of The Medical City in Pasig City, Philippines. Mean percentage error (MPE) determined bias. Modified Bland-Altman analysis was used to perform a visual comparison of the bias and extent of agreement. The proportion of weight estimates within 10% ( ) and within 20% ( ) of actual weight was calculated to determine the overall accuracy.

RESULTS

A total of 220 Filipino children (63.2% male) were recruited. Both the Broselow and PAWPER XL-MAC tapes overestimate the actual weight by an average of 0.4% (95% limit of agreement [LOA] -29.4 to 30.2) and 1.3% (95% LOA -15.3 to 17.9) respectively. Across body mass index (BMI) groups, both tapes overestimate (MPE: +19.2 and +9.3) weight among underweight children and underestimate (MPE: -13.2 and -3.5; MPE: -18.6 and -5.5) weight among overweight and obese children. In measuring estimated weight within 10% and 20% of actual weight, the PAWPER XL-MAC performed best (79.6% and 96.8%).

CONCLUSION

The PAWPER XL-MAC tape performed better as a weight estimation tool compared to Broselow tape across different age groups and BMI-for-age groups of Filipino children. Both tapes tend to overestimate weight among younger and underweight children while underestimating weight among ages 7 to 10 years old, overweight, or obese children.