Comparison of Errors Using Two Length-Based Tape Systems for Prehospital Care in Children

Overview

Journal Prehosp Emerg Care

Publisher Informa Healthcare

Specialty Emergency Medicine

Date 2016 Feb 3

PMID 26836351

Citations 6

Authors

Lara D Rappaport

Lina Brou

Tim Givens

Maria Mandt

Ashley Balakas

Kelley Roswell

Jason Kotas

Kathleen M Adelgais

Affiliations

Soon will be listed here.

Abstract

Background: The use of a length/weight-based tape (LBT) for equipment size and drug dosing for pediatric patients is recommended in a joint statement by multiple national organizations. A new system, known as Handtevy™, allows for rapid determination of critical drug doses without performing calculations.

Objective: To compare two LBT systems for dosing errors and time to medication administration in simulated prehospital scenarios.

Methods: This was a prospective randomized trial comparing the Broselow Pediatric Emergency Tape™ (Broselow) and Handtevy LBT™ (Handtevy). Paramedics performed 2 pediatric simulations: cardiac arrest with epinephrine administration and hypoglycemia mandating dextrose. Each scenario was repeated utilizing both systems with a 1-year-old and 5-year-old size manikin. Facilitators recorded identified errors and time points of critical actions including time to medication.

Results: We enrolled 80 paramedics, performing 320 simulations. For Dextrose, there were significantly more errors with Broselow (63.8%) compared to Handtevy (13.8%) and time to administration was longer with the Broselow system (220 seconds vs. 173 seconds). For epinephrine, the LBTs were similar in overall error rate (Broselow 21.3% vs. Handtevy 16.3%) and time to administration (89 vs. 91 seconds). Cognitive errors were more frequent when using the Broselow compared to Handtevy, particularly with dextrose administration. The frequency of procedural errors was similar between the two LBT systems.

Conclusion: In simulated prehospital scenarios, use of the Handtevy LBT system resulted in fewer errors for dextrose administration compared to the Broselow LBT, with similar time to administration and accuracy of epinephrine administration.

Citing Articles

Is there evidence that length-based tapes with precalculated drug doses increase the accuracy of drug dose calculations in children? A systematic review.

Wells M, Yende P Clin Exp Emerg Med. 2023; 11(2):145-160.

PMID: 38018070 PMC: 11237260. DOI: 10.15441/ceem.23.110.

Weight Estimation for Drug Dose Calculations in the Prehospital Setting - A Systematic Review.

Wells M, Henry B, Goldstein L Prehosp Disaster Med. 2023; 38(4):471-484.

PMID: 37439214 PMC: 10445115. DOI: 10.1017/S1049023X23006027.

Weighty Matters: A Real-World Comparison of the Handtevy and Broselow Methods of Prehospital Weight Estimation.

Knudsen-Robbins C, Pham P, Zaky K, Brukman S, Schultz C, Hecht C Prehosp Disaster Med. 2022; 37(5):616-624.

PMID: 36098467 PMC: 9470517. DOI: 10.1017/S1049023X22001248.

South African pre-hospital emergency care personnel's lived experiences of managing paediatric emergencies: A qualitative research design utilising one-on-one interviews.

Mosca C, Stein C, Lawrence H Health SA. 2021; 26:1558.

PMID: 34394964 PMC: 8335770. DOI: 10.4102/hsag.v26i0.1558.

Effect of Repetitive Simulation Training on Emergency Medical Services Team Performance in Simulated Pediatric Medical Emergencies.

Kothari K, Zuger C, Desai N, Leonard J, Alletag M, Balakas A AEM Educ Train. 2021; 5(3):e10537.

PMID: 34099990 PMC: 8166302. DOI: 10.1002/aet2.10537.

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