The accuracy of drug dose calculation was primarily assessed using the percentage error of the dose: dose errors of 20% were considered to be critical errors. Accuracy was represented by the percentage of estimations falling within 10% of actual weight (PW10). The accuracy of weight estimation of each system was evaluated for overall accuracy. Severe gastroenteritis with hyperkalaemia Upon completion of each six-minute simulation, the participants rotated to the next station until all eight were completed. The time taken to calculate the drug doses was recorded by the time-keeper. The participants used one of four weight-estimation/drug-dosing systems to estimate weight and calculate drug doses at each station, as shown in Fig. hydrocortisone 100 mg/2 mL mix with 8 mL saline: give 6 mL IV). As part of the resuscitation, the participants were required to calculate two drug doses at every station and write a prescription in a format that would allow the drug to be diluted, prepared and administered by another person (e.g. During the study, every participant conducted an abridged, simulated resuscitation at each station, as directed by a timekeeper. Before commencing the simulations, each participant was fully trained in the use of the systems and materials and had sufficient time to practice with them. The aim of this study was to evaluate how accurately four different weight estimation/drug dosing systems, with differing amounts of dosing information, would function during simulated paediatric resuscitation scenarios.Įight simulation stations were used, each recreating an everyday emergency scenario with a child volunteer who simulated the medical condition specified for the scenario (see Table 1). There is substantial concern about the quality of evidence supporting these guidelines, however, which makes it imperative to obtain further research on the on the ability of devices such as the Broselow tape to reduce drug dose calculation errors. The use of mobile phone applications has not previously been evaluated in this context.Ĭurrent major international guidelines recommend the use of length-based tapes with pre-calculated drug doses during paediatric resuscitations. The optimum resuscitation aid, at least in theory, is epitomised by a mobile phone application which could combine both weight estimation and drug dosing. In addition, the effect of inadequate training of healthcare providers, who may use weight estimation and drug-dosing systems less accurately than those who are well-trained and well-practised, may also be significant. Resuscitation aids which contain comprehensive information on drug dilution, preparation and volume-to-administer (complete resuscitation aids) are more likely to result in accurate drug administration than those which contain less comprehensive information. The effects of cognitive stress during emergencies, the complexity of the weight estimation system and the use of an appropriate drug-dosing aid may all influence the accuracy of drug dosing determination as much as the accuracy of the weight estimation itself, ,, ]. While many studies have evaluated the accuracy of different emergency weight estimation systems in children, few studies have evaluated a more important end-point: the accuracy of the drug dose calculations. The purpose of weight estimation in paediatric emergencies is principally to enable the calculation of critically-needed drug doses.
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