Validation of two pediatric resuscitation tapes

Area of Science:

• Pediatric Emergency Medicine
• Clinical Assessment Tools
• Anthropometry

Background:

• Accurate weight estimation is crucial for pediatric emergency care.
• Existing tools like the Broselow tape have limitations in diverse populations.
• The Pediatric Advanced Weight Prediction in the Emergency Room eXtra Length-Mid-arm Circumference (PAWPER XL-MAC) tape offers a potential improvement.

Purpose of the Study:

• To compare the accuracy of the Broselow tape and the PAWPER XL-MAC tape in estimating the actual weights of Filipino children.
• To evaluate the performance of these weight estimation tools across different age and Body Mass Index (BMI) for age groups.

Main Methods:

• A prospective, observational, cross-sectional study was conducted in a pediatric emergency department in the Philippines.
• Mean Percentage Error (MPE) and Modified Bland-Altman analysis were used to assess bias and agreement.
• The proportion of weight estimates within 10% (p10) and 20% (p20) of actual weight determined overall accuracy.

Main Results:

• The PAWPER XL-MAC tape demonstrated better accuracy, with 79.6% of estimates within 10% and 96.8% within 20% of actual weight.
• Both tapes overestimated weight in underweight children and underestimated it in overweight and obese children.
• The PAWPER XL-MAC tape showed less bias (1.3%) compared to the Broselow tape (0.4%) in estimating Filipino children's weight.

Conclusions:

• The PAWPER XL-MAC tape is a more reliable weight estimation tool for Filipino children compared to the Broselow tape.
• Both tools exhibit systematic errors, overestimating in underweight and underestimating in overweight/obese children.
• Clinical application of PAWPER XL-MAC tape is recommended for improved weight estimation in this population.