Page 44 - JSOM Summer 2023

TABLE 2 Age- and Sex-adjusted Associations of Weight and Height as markers for PCCD fit. A chi-square analysis was run by
Compared by Pelvic Circumference Using Multivariate Linear comparing device fit to both patient weight and length, which
Regressions fell on or did not fall on the Broselow Tape scale (i.e., weight
Variable β (95% CI) p-Value below or above 36-kg and height below or above 143-cm, re-
Weight 0.37 (0.11, 0.64) .007 spectively). Both the Pediatric PelvicBinder device fit and the
Height –0.09 (–0.23, 0.05) .211 SAM Pelvic Sling device fit showed significant correlation with
patient weight and length, either falling on or off the Broselow
Tape scale.
TABLE 3 Univariate Analysis of Pediatric PelvicBinder and SAM
Pelvic Sling Device Fit by Broselow Tape Weight Using the Chi-
Square Test Although weight was observed to serve as a better indepen-
Variable Off Scale On Scale Total p-Value dent predictor of pelvic circumference, it is not readily avail-
Pediatric PelvicBinder <.001 able in the prehospital setting and even less so in conflict and
disaster zones. Using the maximum length of the Broselow
Fit 12 47 59 — Tape scale was observed to have greater success in device fit
No Fit 6 0 6 — and is more practical in emergent settings, where obtaining
Total 18 47 65 — patients’ weights through either direct measure or parental es-
Sam Pelvic Sling <.001 timate may not be readily available. Patients with weights and
Fit 14 0 14 — lengths that fell on the Broselow Tape scale had 100% device
No Fit 4 47 51 — fit with the Pediatric PelvicBinder. Differences arose in those
Total 18 47 65 — that fell off the Broselow Tape scale using maximum weight
or maximum length, with those with weights greater than
those listed on the Broselow Tape having a 78% fit with SAM
TABLE 4 Univariate Analysis of Pediatric PelvicBinder and
SAM Pelvic Sling Device Fit by Broselow Tape Length Using Pelvic Sling compared with those with lengths greater than
Chi-Square Test that of the scale having a 92% device fit. Therefore, despite
weight being the best predictor of hip circumference, these re-
Variable Off Scale On Scale Total p-Value sults suggest using height equal to the maximum length on
Pediatric PelvicBinder <.001 the Broselow Tape—143-cm (56-in)—as a cutoff for selecting
Fit 6 53 59 — a PCCD in pediatric populations. The results of this study
No Fit 6 0 6 — support the following recommendations for PCCD use in the
Total 12 53 65 — setting of possible pelvic ring fracture in children >1 year old
Sam Pelvic Sling <.001 (i.e., ambulatory children): (1) a height <143-cm indicates the
Fit 11 3 14 — use of the Pediatric PelvicBinder, and (2) a height >143-cm
No Fit 1 50 51 — indicates the use of the SAM Pelvic Sling. Using 143-cm as a
Total 12 53 65 — dichotomous cutoff point for device selection further allows
the SOF or other prehospital provider to mark a backboard or
other available piece of equipment at that length, thus avoid-
Notably, when the maximum length of the Broselow Tape ing responders being limited by the number of Broselow Tapes
(143-cm) was used as the cutoff, of the 53 patients whose available at that time of an incident.
height fell on the Broselow Tape, 53 (100%) had successful fit
of the Pediatric PelvicBinder; and, of the 12 off the scale, 11 Limitations to this study include cohort sample size and
(91.7%) had successful device fit with the SAM Pelvic Sling. skewed cohort characteristics. Despite the possibility of this
type II statistical error, strong statistically significant correla-
tions were observed, and these data were sufficient for the ex-
Discussion
ploration of factors associated with pelvic circumference that
With the rise of vehicle-ramming attacks around the world and would assist in PCCD selection. Inconsistency in our ability to
their association with pelvic fractures, emergency responders obtain a measured weight versus a parental report of weight
need simple, quick, and effective methods for stabilizing these would be significant were our study aimed at validating vari-
serious injuries. Options for PCCD selection in pediatric popu- ous anthropometric relationships; however, this inconsistency
lations is growing, creating the need for guidelines for efficient accurately reflects the environment in which these devices are
and accurate device selection in emergent settings. To begin used and therefore does not detract from the use of the max-
this study, comparisons of anthropometric measurements be- imum length of the Broselow Tape as a dichotomous variable
tween male and female study subjects were conducted, with- for device selection. Additionally, the sample population age
out significant differences being observed, indicating that was observed to be positively skewed, with mean age being 6
variation in recommendations by sex is unnecessary in this years and the median age being 5 years. This indicates that the
study population. Positive and statistically significant univari- study population was overall younger, with 45 of the 65 study
ate associations between pelvic circumferences were observed participants being younger than 8 years. These cohort demo-
with both measured study variables (i.e., weight and height), graphics increase the potential for an inaccurate representa-
suggesting that they are adequate markers for estimating pel- tion of post-pubertal anthropometric demographics; therefore,
vic circumference. further studies may be required to investigate PCCD selection
in adolescents. However, adult devices have already been well
This study chose to evaluate fit on the Broselow Pediatric studied in their efficacy among skeletally mature patients, and
Emergency Tape scale because it is a common and readily because the purpose of this study was to examine the fit of
available tool already in use for determining the sizing of var- pediatric specific devices, we feel the lack of older patients is
ious pediatric devices. Weight and length were both examined acceptable. Although exertional pressures were not directly

42 | JSOM Volume 23, Edition 2 / Summer 2023