title: Comparison of Errors Using Two Length-Based Tape Systems for Prehospital Care in Children.
abstract: The use of a length/weight-based tape (LBT) for equipment size and drug dosing for pediatric patients is recommended in a joint statement by multiple national organizations. A new system, known as Handtevy™, allows for rapid determination of critical drug doses without performing calculations.
  
  
  
  To compare two LBT systems for dosing errors and time to medication administration in simulated prehospital scenarios.
  
  
  
  This was a prospective randomized trial comparing the Broselow Pediatric Emergency Tape™ (Broselow) and Handtevy LBT™ (Handtevy). Paramedics performed 2 pediatric simulations: cardiac arrest with epinephrine administration and hypoglycemia mandating dextrose. Each scenario was repeated utilizing both systems with a 1-year-old and 5-year-old size manikin. Facilitators recorded identified errors and time points of critical actions including time to medication.
  
  
  
  We enrolled 80 paramedics, performing 320 simulations. For Dextrose, there were significantly more errors with Broselow (63.8%) compared to Handtevy (13.8%) and time to administration was longer with the Broselow system (220 seconds vs. 173 seconds). For epinephrine, the LBTs were similar in overall error rate (Broselow 21.3% vs. Handtevy 16.3%) and time to administration (89 vs. 91 seconds). Cognitive errors were more frequent when using the Broselow compared to Handtevy, particularly with dextrose administration. The frequency of procedural errors was similar between the two LBT systems.
  
  
  
  In simulated prehospital scenarios, use of the Handtevy LBT system resulted in fewer errors for dextrose administration compared to the Broselow LBT, with similar time to administration and accuracy of epinephrine administration.
authors.forename: Lara D
authors.initials: LD
authors.lastname: Rappaport
authors.forename: Lina
authors.initials: L
authors.lastname: Brou
authors.forename: Tim
authors.initials: T
authors.lastname: Givens
authors.forename: Maria
authors.initials: M
authors.lastname: Mandt
authors.forename: Ashley
authors.initials: A
authors.lastname: Balakas
authors.forename: Kelley
authors.initials: K
authors.lastname: Roswell
authors.forename: Jason
authors.initials: J
authors.lastname: Kotas
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Adelgais
mesh_terms: D001837:Body Weights and Measures / Q000295:instrumentation*; D004632:Emergency Medical Services; D005260:Female; D057238:Growth Charts; D006801:Humans; D008297:Male; D008348:Manikins; D008508:Medication Errors / Q000517:prevention & control*; D011446:Prospective Studies
keywords: emergency medical services; medication errors; pediatrics
references.citation: J Biomed Inform. 2009 Apr;42(2):377-81
references.pmid: 18929686
references.citation: Circulation. 2010 Oct 19;122(16 Suppl 2):S466-515
references.pmid: 20956258
references.citation: Ann Emerg Med. 2008 Jul;52(1):35-40.e13
references.pmid: 18407376
references.citation: J Gen Intern Med. 1995 Apr;10(4):199-205
references.pmid: 7790981
references.citation: Ann Emerg Med. 1980 Apr;9(4):183-9
references.pmid: 7369561
references.citation: J Clin Pharmacol. 1994 Nov;34(11):1043-5
references.pmid: 7876393
references.citation: Arch Dis Child. 2005 Jul;90(7):698-702
references.pmid: 15970610
references.citation: J Surg Oncol. 2004 Dec 1;88(3):182-8
references.pmid: 15562454
references.citation: Pediatrics. 2006 Oct;118(4):1493-500
references.pmid: 17015540
references.citation: Pediatr Emerg Care. 1999 Feb;15(1):17-8
references.pmid: 10069305
references.citation: Acad Emerg Med. 2007 May;14(5):500-1; author reply 501-2
references.pmid: 17456560
references.citation: Prehosp Emerg Care. 2000 Jul-Sep;4(3):253-60
references.pmid: 10895922
references.citation: Simul Healthc. 2014 Jun;9(3):174-83
references.pmid: 24401924
references.citation: Prehosp Emerg Care. 2012 Jul-Sep;16(3):374-80
references.pmid: 22443376
references.citation: Pediatrics. 1995 Jul;96(1 Pt 2):173-4
references.pmid: 7596732
references.citation: Arch Pediatr Adolesc Med. 2003 Mar;157(3):229-36
references.pmid: 12622671
references.citation: Prehosp Emerg Care. 2014 Apr-Jun;18(2):295-304
references.pmid: 24401046
references.citation: Ann Emerg Med. 1990 Feb;19(2):173-8
references.pmid: 2301796
references.citation: Prehosp Emerg Care. 2012 Jan-Mar;16(1):59-66
references.pmid: 21999707
references.citation: Prehosp Emerg Care. 2015 Jul-Sep;19(3):441-7
references.pmid: 25658967
references.citation: Pediatrics. 1995 Jul;96(1 Pt 2):199-206
references.pmid: 7596739
references.citation: Acad Emerg Med. 2012 Jan;19(1):37-47
references.pmid: 22251191
references.citation: Prehosp Emerg Care. 2014 Jan-Mar;18(1):52-9
references.pmid: 24134593
references.citation: J Clin Pharmacol. 2002 Jul;42(7):707-10
references.pmid: 12092737
references.citation: Am J Dis Child. 1979 Apr;133(4):376-9
references.pmid: 433852
references.citation: Pediatr Emerg Care. 2011 Dec;27(12):1130-5
references.pmid: 22134229
references.citation: Acad Emerg Med. 2000 Nov;7(11):1194-200
references.pmid: 11073467
references.citation: Pediatr Emerg Care. 2005 Jan;21(1):12-7
references.pmid: 15643317
references.citation: Ann Emerg Med. 1988 Jun;17(6):576-81
references.pmid: 3377285
references.citation: JAMA. 1997 Jan 22-29;277(4):312-7
references.pmid: 9002494
references.citation: Prehosp Emerg Care. 2014 Jan-Mar;18(1):92-7
references.pmid: 24168014
references.citation: Br J Anaesth. 2002 Feb;88(2):283-5
references.pmid: 11878662
references.citation: Prehosp Emerg Care. 2009 Jul-Sep;13(3):345-56
references.pmid: 19499472
references.citation: Am J Emerg Med. 2004 Nov;22(7):526-9
references.pmid: 15666254
references.citation: Circulation. 2010 Nov 2;122(18 Suppl 3):S876-908
references.pmid: 20956230
references.citation: Ann Emerg Med. 2000 Jul;36(1):33-8
references.pmid: 10874233
references.citation: J Emerg Nurs. 2001 Dec;27(6):568-70
references.pmid: 11712011
references.citation: Acad Emerg Med. 2000 Jul;7(7):779-86
references.pmid: 10917328
references.citation: Acad Emerg Med. 2000 Nov;7(11):1183-8
references.pmid: 11073465