Utility of the broselow tape in Emergency Departments

  • Michael Khouli Indiana University School of Medicine
  • Mario I. Ortiz Universidad Autónoma del Estado de Hidalgo
  • Georgina Romo-Hernández Hospital del Niño DIF
Keywords: Broselow Tape,Leffler Formula, Pediatric Emergency Medicine, Theron Formula, Weight estimation.

Abstract

Since medication doses and equipment size vary with patient weight, accurately estimating the weight of pediatric emergency department patients is crucial for optimizing medical care. Often critically ill children cannot be safely weighed in the emergency department. While several different methods for estimating weight have been developed, one validated tool for rapidly estimating patient weight is the Broselow tape. However, some studies have found that this tape is less accurate in different settings, including those with a high prevalence of obesity or malnutrition. This review discusses the accuracy of the tape in several different populations, including children in various countries and those with obesity, compares it to other methods of weight estimation, and briefly addresses implementation of the Broselow tape in the emergency department.

References

1 . So T, Farrington E, Absher RK, Evaluation of the Accuracy of Different Methods Used to Estimate Weights in the Pediatric Population. Pediatrics2009;123;e1045-e1051.

2 . Luten R, Wears RL, Broselow J, Croskerry P, Joseph MM, Frush K. Managing the unique size-related issues of pediatric resuscitation: reducing cognitive load with resuscitation aids. Acad Emerg Med. 2002;9:840–7.

3 . Lubitz D, Seidel J, Chameides L, Luten R, Zaritsky A, Campbell F. A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group. Annals of Emergency Medicine. 1988;17:576-81.

4 . Kleinman ME, Chameides L, Schexnayder SM, et al. Pediatric Advanced Life Support: 2010 American Heart Association Guidelines for cardiopulmonary resucitation and emergency crdiovascular care. Pediatrics. 2010;126;e1361-e1399.

5 . Rosenberg M, Greenberger S, Rawal A, et al. Comparison of Broselow tape measurements versus physician estimations of pediatric weights. American Journal of Emergency Medicine. 2011; 29(5): 482-488.

6 . Cattermole GN, Leung PYM, Mak PSK, Graham CA, Rainer TH. Mid-arm circumference can be used to estimate children’s weight. Resuscitation, 2010;81(9): 1105-1110.

7 . Nieman CT, Manacci CF, Super DM, Mancuso C, Fallon WF Jr. Use of the Broselow tape may result in the underresuscitation of children. Acad Emerg Med. 2006; 13:1011–9.

8 . Knight JC, Nazim M, Riggs D, Channel J, Mullet C, Vaughan R, Wilson A. Is the Broselow Tape a Reliable Indicator for Use in All Pediatric Trauma Patients? Pediatric Emergency Care. 2011; 27(6):479-82

9 . Bourdeau S, Copeland J, Milne W, Accuracy of the Broselow tape in estimating the weight of First Nations children. Can J Rural Med 2011;16(4):121-125.

10 . Ramarajan N, Krishnamoorthi R, Strehlow M, Quinn J, Mahadevan SV. Internationalizing the Broselow tape: how reliable is weight estimation in Indian children. Acad Emerg Med. 2008; 15:431–6.

11 . Jang HY, Shin SD, Kwak YH. Can the Broselow tape be used to estimate weight and endotracheal tube size in korean children? Acad Emerg Med. 2007; 14:489–91.

12 . Mackway-Jones K, Molyneux E, Phillips B, Wieteska S, editors. Advanced pediatric life support: The practical approach. 3rd edn. London: BMJ Publishing Group; 2001; p 7.

13 . Kun WM, Cheng KM, Yuen MC, Tung WK, How Good is the Broselow Tape Measurement for Estimation of Body Weights in Paediatric Patients for Application in Hong Kong. HK J Paediatr 2000;5:25-30.

14 . Geduld H, Hodkinson PW, Wallis LA. Validation of weight estimation by age and length based methods in the Western Cape, South Africa population. Emerg Med J 2011;28:856-860.

15 . Theron L, Adams A, Jansen K, Robinson E. Emergency weight estimation in Pacific Island and Maori children who are large-for-age. Emerg Med Australas. 2005; 17:238–43.

16 . Kaji AH, Gausche-Hill M, Conrad H, Young KD, Koenig WJ, Dorsey E, Lewis RJ. Emergency medical services system changes reduce pediatric epinephrine dosing erros in the prehospital setting. Pediatrics 2006;118;1493-1500.

17 . Agarwal S, Swanson S, Murphy A, Yaeger K, Sharek P, Halamek LP. Comparing the utility of a standard pediatric resuscitation cart with a pediatric resuscitation cart based on the Broselow tape: A randomized, controlled, crossover trial involving simulated resuscitation scenariosPediatrics2005;116;e326-e333.

18 . Fineberg SL, Arendts G. Comparison of two methods of pediatric resuscitation and critical care management. Ann Emerg Med. 2008;52:35-40.
Published
2014-01-05

Most read articles by the same author(s)