ObjectiveTo prospectively compare the actual weights of Australian children in an ethnically diverse metropolitan setting with the predicted weights using the Paediatric Advanced Weight Prediction in the Emergency Room (PAWPER) tape, Broselow tape, Mercy system and calculated weights using the updated Advanced Paediatric Life Support (APLS), Luscombe and Owens and Best Guess formulae.MethodsA prospective, cross-sectional, observational, blinded, convenience study conducted at the Children's Hospital at Westmead Paediatric Emergency Department in Sydney, Australia. Comparisons were made using Bland-Altman plots, mean difference, limits of agreement and estimated weight within 10% and 20% of actual weight.Results199 patients were enrolled in the study with a mean actual weight of 27.2 kg (SD 17.2). Length-based tools, with or without body habitus adjustment, performed better than age-based formulae. When measuring estimated weight within 10% of actual weight, PAWPER performed best with 73%, followed by Mercy (69%), PAWPER with no adjustment (62%), Broselow (60%), Best Guess (47%), Luscombe and Owens (41%) and revised APLS (40%). Mean difference was similar across all methods ranging from 0.4 kg (0.0, 0.9) for Mercy to −2.2 kg (−3.5, −0.9) for revised APLS. Limits of agreement were narrower for the length-based tools (−5.9, 6.8 Mercy; −8.3, 5.6 Broselow; −9.0, 7.1 PAWPER adjusted; −12.1, 9.2 PAWPER unadjusted) than the age-based formulae (−18.6, 17.4 Best Guess; −19.4, 15.1 revised APLS, −21.8, 17.7 Luscombe and Owens).ConclusionIn an ethnically diverse population, length-based methods with or without body habitus modification are superior to age-based methods for predicting actual body weight. Body habitus modifications increase the accuracy and precision slightly.

During standardised paediatric simulations multiple incidents of suboptimal care have been identified and multiple causation factors attributed to these. Educators should use this information to adapt current training programs to encompass these factors.

Objective: To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. Methods: A prospective survey of scenario participants and faculty completing in situ and centre-based paediatric simulations.Results: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre-based simulations. Scenario participant responses showed significantly higher ratings for the centre-based simulations for respiratory rate (P = 0.007), pulse (P = 0.036), breath sounds (P = 0.002), heart sounds (P < 0.001) and patient noises (P < 0.001). There was a significant difference in overall rating of the scenario reality by scenario participants in favour of the centre-based simulations (P = 0.005); however, there was no significant difference when rating participant engagement (P = 0.11) and participant learning (P = 0.77). With the centre-based scenarios, nurses rated the reality of the respiratory rate (P < 0.001), blood pressure (P = 0.016) and abdominal signs (P = 0.003) significantly higher than doctors. Nurses rated the overall reality higher than doctors for the centre simulations (96.8% vs 84.2% rated as realistic, P = 0.041), which was not demonstrated in the in situ scenarios (76.2% vs 73.5%, P = 0.65). Conclusion: Some aspects of in situ simulations may be less 'real' than centre-based simulations, but there was no significant difference in selfreported engagement or learning by scenario participants. Low fidelity, in situ simulation provides adequate realism for engagement and learning.

Aim:A key competency for all health-care workers (HCWs) who care for children is the ability to respond to a child in respiratory or cardiorespiratory arrest. However, evidence suggests that medical and nursing staff may not have the knowledge and clinical skills to respond to these emergencies. The aim of this project was to create a standardised, evidence-based, paediatric life support course that would be available free to all HCWs in New South Wales (NSW), including NSW Ambulance. Methods: A paediatric life support course was designed along current education principles. It used e-learning as pre-learning and a face-toface short practical course, combining team work and communication with practical paediatric resuscitation skills training. The programme was designed to empower local trainers to deliver a standardised course to local participants. Results: A total of 14 000 participants have completed the mandatory e-learning component, and over 8600 participants have completed the short practical course, across all NSW Local Health Districts, including NSW Ambulance. RESUS4KIDS has also been adopted by the universities of Sydney and Newcastle undergraduate medical and nursing programmes. Outside of NSW and ACT, over 400 participants have completed the course in facilities in Queensland, South Australia, Victoria and the Northern Territory. Conclusion:We have developed a course that is available, at no cost to individuals or facilities, to all HCWs in NSW, including students, paramedics and general practitioners. We would encourage all other jurisdictions to consider adopting the programme.

BackgroundEffective cardiopulmonary resuscitation saves lives. Health professionals who care for acutely unwell children need to be prepared to care for a child in arrest. Hospitals must ensure that their staff have the knowledge, confidence and ability to respond to a child in cardiac arrest. RESUS4KIDS is a programme designed to teach paediatric resuscitation to health care professionals who care for acutely unwell children. The programme is delivered in two components: an e–learning component for pre-learning, followed by a short, practical, face-to-face course that is taught using the round-the-table teaching approach.ContextRound-the-table teaching is a novel, evidence-based small group teaching approach designed to teach paediatric resuscitation skills and knowledge. Round-the-table teaching uses a structured approach to managing a collapsed child, and ensures that each participant has the opportunity to practise the essential resuscitation skills of airway manoeuvres, bag mask ventilation and cardiac compressions.InnovationRound-the-table teaching is an engaging, non-threatening approach to delivering interdisciplinary paediatric resuscitation education. The methodology ensures that all participants have the opportunity to practise each of the different essential skills associated with the Danger, Response, Send for help, Airway, Breathing, Circulation, Defibrillation or rhythm recognition (DRSABCD) approach to the collapsed child.ImplicationsRound-the-table teaching is based on evidence-based small group teaching methods. The methodology of round-the-table teaching can be applied to any topic where participants must demonstrate an understanding of a sequential approach to a clinical skill.Round-the-table teaching uses a structured approach to managing a collapsed child