Pediatric emergency backpacks-effects of using xABCDE- and Broselow-systems on pediatric emergency care.

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.