University of Pittsburgh School of Medicine, Pittsburgh, PennsylvaniaUSA.
Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CaliforniaUSA.
Prehosp Disaster Med. 2022 Oct;37(5):616-624. doi: 10.1017/S1049023X22001248.
The majority of pediatric medications are dosed according to weight and therefore accurate weight assessment is essential. However, this can be difficult in the unpredictable and peripatetic prehospital care setting, and medication errors are common. The Handtevy method and the Broselow tape are two systems designed to guide Emergency Medical Services (EMS) providers in both pediatric patient weight estimation and medication dosing. The accuracy of the Handtevy method of weight estimation as practiced in the field by EMS has not been previously examined.
The primary objective of this study was to examine the field performance of the Handtevy method and the Broselow tape with respect to prehospital patient weight estimation.
This was a retrospective chart review of trauma and non-trauma patients transported by EMS to the emergency department (ED) of a quaternary care children's hospital from January 1, 2021 through June 30, 2021. Demographic data, ED visit information, prehospital weight estimation, and medication dosing were collected and analyzed. Scale-based weight from the ED was used as the standard for comparison.
A total of 509 patients <13 years of age were included in this study. The EMS providers using the Broselow method estimated patient weight to within +/-10% of ED scale weight in 51.3% of patients. When using the Handtevy method, the EMS providers estimated patient weight to within +/-10% of ED scale weight in 43.7% of patients. When comparing the Handtevy versus Broselow method of prehospital weight estimation, there was no significant association between method and categorized weight discrepancy (over, under, or accurate estimates - defined as within 10% of ED scale weight; P = .25) or percent weight discrepancy (P = .75). On average, prehospital weight estimation was 6.33% lower than ED weight with use of the Handtevy method and 6.94% lower with use of the Broselow method.
This study demonstrated no statistically significant difference between the use of the Handtevy or Broselow methods with respect to prehospital weight estimation. While further research is necessary, these results suggest similar field performance of the Broselow and Handtevy methods.
大多数儿科药物都是根据体重给药的，因此准确的体重评估至关重要。然而，在不可预测和流动的院前护理环境中，这可能很困难，药物错误很常见。汉特维方法和布鲁塞洛带是两种旨在指导急救医疗服务（EMS）提供者进行儿科患者体重估计和药物剂量的系统。汉特维方法在现场由 EMS 实践的体重估计的准确性尚未被先前检查过。
本研究的主要目的是检查汉特维方法和布鲁塞洛带在院前患者体重估计方面的现场表现。
这是对 2021 年 1 月 1 日至 2021 年 6 月 30 日期间由 EMS 送往四级儿童医院急诊科的创伤和非创伤患者的回顾性图表审查。收集并分析人口统计学数据、急诊科就诊信息、院前体重估计和药物剂量。使用 ED 秤重作为比较的标准。
共有 509 名<13 岁的患者纳入本研究。使用布鲁塞洛方法的 EMS 提供者在 51.3%的患者中，将患者体重估计到 ED 秤重的+/-10%以内。当使用汉特维方法时，EMS 提供者将患者体重估计到 ED 秤重的+/-10%以内，占 43.7%的患者。当比较院前体重估计的汉特维与布鲁塞洛方法时，两种方法与分类体重差异（高估、低估或准确估计-定义为在 ED 秤重的 10%以内；P=.25）或体重差异百分比（P=.75）之间没有显著关联。平均而言，使用汉特维方法进行院前体重估计比 ED 体重低 6.33%，使用布鲁塞洛方法低 6.94%。
本研究表明，汉特维或布鲁塞洛方法在院前体重估计方面没有统计学上的显著差异。虽然需要进一步研究，但这些结果表明布鲁塞洛和汉特维方法的现场性能相似。
