Weighing the pediatric patient during trauma resuscitation and its concordance with estimated weight using broselow luten emergency tape

Abstract

OBJECTIVE: Obtaining an accurate weight is crucial during pediatric trauma/medical resuscitation. Currently, length-based weight estimations are used. Study objective was to assess feasibility of obtaining actual weights of children during trauma resuscitation and study its concordance with length-based estimated weight using the Broselow Pediatric Emergency Tape. METHODS: Pediatric trauma patients 0 to 14 years old presenting to a tertiary care pediatric trauma center between November 2008 and October 2009 were enrolled prospectively. Length-based weight estimation was done on patient arrival using the Broselow tape; in addition, an actual patient weight was recorded using the trauma stretcher integrated weighing scale. RESULTS: Two hundred thirty-one patients were eligible and enrolled. Weights were recorded in 145 children (63.2%). In 27 patients (18.6%) whose body length exceeded Broselow tape range, weight was measured using stretcher scale only. The remaining 118 patients (mean age, 5.0 [SE ± 0.3] years; 67% male) were used for correlation analysis. There was good correlation (Pearson correlation coefficient, r = 0.86) between estimated weight and measured weight. However, Bland-Altman analysis showed mean bias +2.6 kg (95% confidence interval [CI], 1.6-3.6 kg); lower/upper limits of agreement were -8.3 kg (CI, -10.0 to -6.6 kg) and 13.5 kg (CI, 11.7-15.2 kg). CONCLUSIONS: It is possible to obtain an actual patient weight during pediatric trauma resuscitation. Length-based estimated weight using Broselow tape underestimated weight by 2.6 kg; the mean error was greatest in the highest weight category. Copyright © 2012 by Lippincott Williams & Wilkins.