Pediatric Tape: Accuracy and Medication Delivery in the National Park Service
Introduction: The objective is to evaluate the accuracy of medication dosing and the time to medication administration in the prehospital setting using a novel length-based pediatric emergency resuscitation tape. Methods: This study was a two-period, two-treatment crossover trial using simulated...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2015-10-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/16b6v6p3 |
| _version_ | 1819211188891811840 |
|---|---|
| author | Danielle D. Campagne Megann Young Jedediah Wheeler Geoff Stroh |
| author_facet | Danielle D. Campagne Megann Young Jedediah Wheeler Geoff Stroh |
| author_sort | Danielle D. Campagne |
| collection | DOAJ |
| description | Introduction: The objective is to evaluate the accuracy of medication dosing and the time to
medication administration in the prehospital setting using a novel length-based pediatric emergency
resuscitation tape.
Methods: This study was a two-period, two-treatment crossover trial using simulated pediatric
patients in the prehospital setting. Each participant was presented with two emergent scenarios;
participants were randomized to which case they encountered first, and to which case used the
National Park Service (NPS) emergency medical services (EMS) length-based pediatric emergency
resuscitation tape. In the control (without tape) case, providers used standard methods to determine
medication dosing (e.g. asking parents to estimate the patient’s weight); in the intervention (with
tape) case, they used the NPS EMS length-based pediatric emergency resuscitation tape. Each
scenario required dosing two medications (Case 1 [febrile seizure] required midazolam and
acetaminophen; Case 2 [anaphylactic reaction] required epinephrine and diphenhydramine). Twenty
NPS EMS providers, trained at the Parkmedic/Advanced Emergency Medical Technician level,
served as study participants.
Results: The only medication errors that occurred were in the control (no tape) group (without tape:
5 vs. with tape: 0, p=0.024). Time to determination of medication dose was significantly shorter
in the intervention (with tape) group than the control (without tape) group, for three of the four
medications used. In case 1, time to both midazolam and acetaminophen was significantly faster in
the intervention (with tape) group (midazolam: 8.3 vs. 28.9 seconds, p=0.005; acetaminophen: 28.6
seconds vs. 50.6 seconds, p=0.036). In case 2, time to epinephrine did not differ (23.3 seconds vs.
22.9 seconds, p=0.96), while time to diphenhydramine was significantly shorter in the intervention
(with tape) group (13 seconds vs. 37.5 seconds, p<0.05).
Conclusion: Use of a length-based pediatric emergency resuscitation tape in the prehospital setting
was associated with significantly fewer dosing errors and faster time-to-medication administration in
simulated pediatric emergencies. Further research in a clinical field setting to prospectively confirm
these findings is needed. |
| first_indexed | 2024-12-23T06:23:06Z |
| format | Article |
| id | doaj.art-12091f9ba0fa47269619a2ece3d83d1b |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-23T06:23:06Z |
| publishDate | 2015-10-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-12091f9ba0fa47269619a2ece3d83d1b2022-12-21T17:57:09ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182015-10-0116566567010.5811/westjem.2015.6.25618Pediatric Tape: Accuracy and Medication Delivery in the National Park ServiceDanielle D. Campagne0Megann Young1Jedediah Wheeler2Geoff Stroh3University of California, San Francisco – Fresno Medical Education Program, Department of Emergency Medicine, Fresno, CaliforniaUniversity of California, San Francisco – Fresno Medical Education Program, Department of Emergency Medicine, Fresno, CaliforniaUniversity of California, San Francisco – Fresno Medical Education Program, Department of Emergency Medicine, Fresno, CaliforniaUniversity of California, San Francisco – Fresno Medical Education Program, Department of Emergency Medicine, Fresno, CaliforniaIntroduction: The objective is to evaluate the accuracy of medication dosing and the time to medication administration in the prehospital setting using a novel length-based pediatric emergency resuscitation tape. Methods: This study was a two-period, two-treatment crossover trial using simulated pediatric patients in the prehospital setting. Each participant was presented with two emergent scenarios; participants were randomized to which case they encountered first, and to which case used the National Park Service (NPS) emergency medical services (EMS) length-based pediatric emergency resuscitation tape. In the control (without tape) case, providers used standard methods to determine medication dosing (e.g. asking parents to estimate the patient’s weight); in the intervention (with tape) case, they used the NPS EMS length-based pediatric emergency resuscitation tape. Each scenario required dosing two medications (Case 1 [febrile seizure] required midazolam and acetaminophen; Case 2 [anaphylactic reaction] required epinephrine and diphenhydramine). Twenty NPS EMS providers, trained at the Parkmedic/Advanced Emergency Medical Technician level, served as study participants. Results: The only medication errors that occurred were in the control (no tape) group (without tape: 5 vs. with tape: 0, p=0.024). Time to determination of medication dose was significantly shorter in the intervention (with tape) group than the control (without tape) group, for three of the four medications used. In case 1, time to both midazolam and acetaminophen was significantly faster in the intervention (with tape) group (midazolam: 8.3 vs. 28.9 seconds, p=0.005; acetaminophen: 28.6 seconds vs. 50.6 seconds, p=0.036). In case 2, time to epinephrine did not differ (23.3 seconds vs. 22.9 seconds, p=0.96), while time to diphenhydramine was significantly shorter in the intervention (with tape) group (13 seconds vs. 37.5 seconds, p<0.05). Conclusion: Use of a length-based pediatric emergency resuscitation tape in the prehospital setting was associated with significantly fewer dosing errors and faster time-to-medication administration in simulated pediatric emergencies. Further research in a clinical field setting to prospectively confirm these findings is needed.http://escholarship.org/uc/item/16b6v6p3PediatricsMedication dosingNational Park ServiceWilderness MedicineEMS |
| spellingShingle | Danielle D. Campagne Megann Young Jedediah Wheeler Geoff Stroh Pediatric Tape: Accuracy and Medication Delivery in the National Park Service Western Journal of Emergency Medicine Pediatrics Medication dosing National Park Service Wilderness Medicine EMS |
| title | Pediatric Tape: Accuracy and Medication Delivery in the National Park Service |
| title_full | Pediatric Tape: Accuracy and Medication Delivery in the National Park Service |
| title_fullStr | Pediatric Tape: Accuracy and Medication Delivery in the National Park Service |
| title_full_unstemmed | Pediatric Tape: Accuracy and Medication Delivery in the National Park Service |
| title_short | Pediatric Tape: Accuracy and Medication Delivery in the National Park Service |
| title_sort | pediatric tape accuracy and medication delivery in the national park service |
| topic | Pediatrics Medication dosing National Park Service Wilderness Medicine EMS |
| url | http://escholarship.org/uc/item/16b6v6p3 |
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