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Broselow®-Tape und Pädiatrisches Notfalllineal im Vergleich

Genauigkeit der Gewichtsschätzung

Comparison of Broselow® tape and pediatric emergency ruler

Accuracy of weight estimation

  • Pädiatrische Notfälle
  • Published:
Notfall + Rettungsmedizin Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Eine Gewichtsangabe ist in präklinischen pädiatrischen Notfällen essenziell für die korrekte Medikamentendosierung. Da diese jedoch oft nicht verfügbar ist, wurden längenbasierte Instrumente zur Gewichtsschätzung entwickelt. Zwei davon sind das Broselow®-Tape (BT) und das Pädiatrische Notfalllineal (PNL).

Ziel

BT und PNL wurden hinsichtlich ihrer längenbasierten Gewichtsschätzung verglichen.

Material und Methoden

Die im elektronischen „patient data management system“ von 2010 bis 2011 gesammelten Daten der Kinderanästhesieabteilung des Universitäts-Kinderspitals Zürich wurden retrospektiv analysiert. In diese Studie eingeschlossen wurden Patienten mit dokumentiertem Alter, Geschlecht und Körpergewicht sowie mit gemessener Körperlänge im gemeinsamen Längenbereich der Notfallbänder. Das mithilfe des BT bzw. PNL geschätzte Gewicht wurde mit dem bei Klinikaufnahme ermittelten tatsächlichen Patientengewicht verglichen. Zur statistischen Analyse wurden Wilcoxon- und McNemar-Tests sowie die Bland-Altman-Biasanalyse verwendet. Die Ergebnisse sind als Median (Interquartile) angegeben.

Ergebnisse

Es wurden 3273 Patienten eingeschlossen. Der Altersmedian lag bei 3,62 Jahren (1,13–6,48 Jahre), das Gewicht bei 15,1 kg (9,42–21,5 kg) und die Körperlänge bei 99,0 cm (75,5–118,0 cm). Das BT zeigte bezüglich der Gewichtsschätzung im Vergleich zum PNL eine statistisch signifikant geringere Abweichung (8,57 vs. 9,23 %; p < 0,001). Mit 57,4 % der Fälle lag das BT signifikant häufiger im ± 10 %-Intervall (PNL: 53,6 %; p < 0,001) und mit 13,7 % signifikant seltener im > 20 %-Intervall (PNL: 17,8 %; p < 0,001). Mit dem BT wurde das Gewicht weniger häufig unterschätzt als mit dem PNL (36,7 vs. 41,8 %; p < 0,001).

Schlussfolgerung

Mit dem BT lässt sich das Körpergewicht präziser einschätzen als mit dem PNL. Bei einem erheblichen Anteil der Patienten liegt die Abweichung außerhalb des ± 10 %-Intervalls.

Abstract

Background

Knowledge of a patient’s body weight is essential for correct dosing of drugs. In pediatric prehospital emergency situations this information is often not available. In addition to age-based formulae for weight calculation, so-called body length-based tools have been developed, two of them are the Broselow® tape (BT) available in the USA and the pediatric emergency ruler (PNL, pädiatrische Notfalllineal) developed in Germany.

Objective

Comparison of the BT and PNL methods for estimation of body weight based on patient body length from retrospective data of a pediatric university hospital.

Material and methods

Data from the department for anesthesia of the University Children’s Hospital in Zurich, Switzerland from 2010 to 2011 were analyzed using an electronic patient data management system (PDMS). Patients with complete data (i.e. age, gender and body weight) and a body length suitable for both devices were included in this study. The body weight estimated by the BT and the PNL were compared with the body weight measured during hospital admission. Wilcoxon and McNemar tests as well as Bland-Altman bias analysis were used for statistical analysis. The results are presented as medians (interquartiles).

Results

A total of 3273 patients with a median age of 3.62 years (range 1.13–6.48 years), weight 15.1 kg (9.42–21.5 kg) and body length 99.0 cm (75.5–118.0 cm) were included in the study. The use of BT showed a statistically significant lower deviation compared to the PNL (8.57 % vs. 9.23 %, p < 0.001). The BT was significantly more often within the ± 10 % interval with 57.4 % (PNL 53.6 %, p < 0.001) and significantly less within the > 20 % interval with 13.7 % (PNL 17.8 %, p < 0.001). The BT underestimated weight less often than the PNL (36.7 % vs. 41.8 %, p < 0.001).

Conclusion

The BT estimated body weight more precisely than the PNL; however, weight was estimated beyond the ± 10 % interval in a major portion of patients by both methods.

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Correspondence to A. R. Schmidt.

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A.R. Schmidt, T. Haas, P. Bühler, K. Ruetzler, M. Weiss und A. Schmitz geben an, dass kein Interessenkonflikt besteht.

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Schmidt, A., Haas, T., Buehler, K. et al. Broselow®-Tape und Pädiatrisches Notfalllineal im Vergleich. Notfall Rettungsmed 19, 129–135 (2016). https://doi.org/10.1007/s10049-015-0070-4

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  • DOI: https://doi.org/10.1007/s10049-015-0070-4

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