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Pediatric emergency backpacks-effects of using xABCDE- and Broselow-systems on pediatric emergency care
Bastian Brune1,2, Doreen Lemm3, Maximilian Wolf4
1Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany. bastian.brune@uk-essen.de.
Insights
The Broselow-system, which organizes pediatric emergency backpacks by patient size and weight, proved more effective than the xABCDE-system in a study involving 115 emergency medical service personnel. Participants found equipment faster and rated the Broselow-system superior for pediatric emergencies.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Medical Equipment Management
Background:
- Pediatric emergencies present unique challenges for emergency medical service (EMS) personnel regarding expertise and equipment.
- Systematic structuring of pediatric emergency backpacks is crucial to address specific size and weight requirements.
Purpose of the Study:
- To compare the efficacy and usability of two pediatric emergency backpack systems: one based on the xABCDE-system and another on the Broselow-system (patient measurements).
- To evaluate the intuitiveness and practical application of each system during simulated pediatric emergencies.
Main Methods:
- A prospective, randomized study involving 115 participants.
- Participants performed material searches and simulated pediatric resuscitation scenarios using both backpack systems.
- Evaluations included objective time measurements for material retrieval and subjective self-assessment of performance and system usability.
Main Results:
- The Broselow-system demonstrated significantly faster retrieval of size-specific materials (e.g., laryngeal mask) and other essential items (e.g., Magill forceps, venous catheters).
- Participants were quicker in resuscitation simulations and selecting appropriate interventions when using the Broselow-system.
- Overall evaluation showed participants preferred the Broselow-system and rated their own performance higher compared to the xABCDE-system.
Conclusions:
- The Broselow-system, organized by patient size and weight, is superior in practical application and user evaluation compared to pure xABCDE-structured systems for pediatric emergency backpacks.
- Size and weight-based sorting is recommended over solely xABCDE-based systems for pediatric emergency equipment.
- Further research should investigate these systems in more complex simulations and real-world emergency operations.
Background:
Pediatric emergencies are a challenge for emergency medical service (EMS) personnel regarding medical expertise and equipment. To address the special requirements in terms of size and weight, attempts are being made to systematically structure pediatric emergency backpacks.
Objectives:
The aim of the study was to compare two pediatric emergency backpacks. One structured according to the xABCDE-system, the other to the Broselow-system based on patients' measurements.
Methods:
In total, 115 participants underwent exercises and emergency scenario simulations with two pediatric emergency backpack systems in a prospective, randomized study. First, they performed a material search of six items to test the intuitiveness of both backpack systems. Later, they used the backpacks in the simulation of a pediatric resuscitation and carried out self-assessment and backpack system evaluation.
Results:
The handling of the Broselow-system was easier for the participants. Particularly size-specific materials (laryngeal mask (xABCDE vs. Broselow: 61.2 ± 31.3 vs. 24.5 ± 14.2 s, p < 0.001)), but also other materials (Magillpliers (37.2 ± 23.3 vs. 7.9 ± 6.1 s, p < 0.001), peripheral venous catheter (12.7 ± 5.7 vs. 6.6 ± 2.7 s, p < 0.001), pupil lamp (both 17.9 ± 6.9 vs. 16.0 ± 6.9 s, p < 0.05)) were found faster. The participants were faster in the resuscitation simulation and selection of large-scale measures using the Broselow-system (e.g. laryngeal mask (187.6 ± 72.6 vs. 155.1 ± 63.5 s, p = 0.001) and preparation of the medication administration in the appropriate dosage (243.0 ± 73.9 vs. 219.8 ± 60.2 s, p < 0.05)) and rated the Broselow-system as well as their own performance better in all evaluation categories (p < 0.001).
Conclusions:
As the Broselow-system coded according to size and weight was ranked better in practical application and evaluation, the size and weight-based sorting should be preferred to pure xABCDE systems. The comparison of the different backpack systems should further be tested in more complex simulations and real operations. What is known? •In emergency medicine, patient care follows the structured xABCDE approach to prioritize life-saving interventions. This algorithm is established in both prehospital and in-hospital settings. What is new? • We present the first comparison of two pediatric emergency backpacks structured by the xABCDE algorithm. Both systems were tested in 2 exercises (material search & resuscitation simulation) in randomized order. Participants completed questionaries on the backpacks and their own performance.
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