A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group

Lubitz, Deborah S; Seidel, James S.; Chameides, Leon; Luten, Robert; Zaritsky, Arno; Campbell, Frederick W.

doi:10.1016/s0196-0644(88)80396-2

Cited by 213 publications

(198 citation statements)

References 4 publications

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“…The BT was developed over 30 years ago and was a great advance in standardizing pediatric resuscitation. 3,4 It reduced the amount of memorization, estimation, and calculations during critical illnesses and trauma. However, the serious trend of childhood obesity has called into question the validity of a length-based technology.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The Broselow Pediatric Emergency Tape (BT) was developed in the late 1980s as a tool to determine a child's weight based on length and has become the standard method in many emergency departments (EDs). 3,4 The worldwide childhood obesity epidemic, however, gives rise to the question of whether the BT is still accurate. In 2002, the Broselow 2002A tape was introduced, which accommodated the newer National Health and Nutrition Examination Survey (NHANES) III reference intervals.…”

Section: Ré Sumémentioning

confidence: 99%

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Ontario children have outgrown the Broselow tape

Milne

Yasin

Knight

et al. 2012

CJEM

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Objective: The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a wellestablished length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort. Methods: Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated. Results: A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r 5 0.95577, p , 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% 6 16.9% SD, 95% CI 226.0-40.2). The BT had an $ 10% PE 43.7% of the time. Conclusions: Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy. RÉ SUMÉObjectif: L'é chelle de Broselow (Broselow Tape [ Bien que les poids estimé s à l'aide de l'é chelle de Broselow aient é té corré lé s avec les poids ré els (r 5 0,95577, p , 0,0001), l'é chelle de Broselow a sous-estimé le poids ré el de 1,62 kg (7,1 % 6 16,9 % é cart-type, IC à 95 %: 26,0 à 40,2). L'é chelle de Broselow avait un $ 10 % PE 43,7 % du temps. Conclusions: Bien que l'é chelle de Broselow reste une mé thode efficace d'estimation du poids en pé diatrie, elle ne s'est pas montré e exacte et tend à sous-estimer le poids des enfants en Ontario. Tant que l'on n'aura pas dé veloppé d'outil de mesure plus pré cis pour les services d'urgence, les mé decins doivent ê tre conscients de cette divergence.

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Section: Discussionmentioning

confidence: 99%

Section: Ré Sumémentioning

confidence: 99%

Ontario children have outgrown the Broselow tape

Milne

Yasin

Knight

et al. 2012

CJEM

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“…16,17 The Broselow pediatric emergency tape was designed to alleviate a number of challenges in emergency care of children. 18 The Broselow tape is a 146.5 cm strip of laminated paper divided into colored regions that correspond to patient height. The colors are subdivided into different kilogram weights.…”

Section: Assessment Of Disaster Preparedness In the United Statesmentioning

confidence: 99%

Disaster Planning for Pediatrics

Branson

2011

Respir Care

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Natural and man-made disasters are inevitable and appear to be more common in the current age. Substantial time and effort have been invested and millions of dollars spent on disaster prevention and management. An important oversight in this planning has been the special needs of children. The vulnerability of children and their physiologic characteristics place them at increased risk during a disaster. Importantly, reunification with family and assurance of safety in this vulnerable group is a priority. This paper addresses issues related to pediatric needs, the medical system's shortcomings in caring for children, and recommendations for action.

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“…During emergencies, actual weight generally cannot be measured and, if medications are required, then an estimate of weight is required to enable the calculation of drug doses [1]. It follows that if the weight estimate is not accurate then the resulting drug dose will not be accurate, which may result in patient harm [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

High-tech adjuncts to emergency weight estimation: Point-of-care ultrasound and point-of-care bioelectrical impedance measurements can increase the accuracy of length-based weight estimation in children

Wells¹,

Goldstein²,

Bentley³

2017

Trauma Emerg Care

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Introduction: An accurate and reliable method of estimating weight in sick obese children, for purposes of drug dosing calculations, has proved to be elusive. Incorporating the use of high-tech, point-of-care technology into weight-estimation methodology has not been evaluated before. We aimed to determine if ultrasound and bioelectrical impedance measurements could be used in combination with the PAWPER XL tape (PTXL) to increase the accuracy of total body weight (TBW), ideal body weight (IBW) and fat-free mass (FFM) estimation.

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A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group

Cited by 213 publications

References 4 publications

Ontario children have outgrown the Broselow tape

Ontario children have outgrown the Broselow tape

Disaster Planning for Pediatrics

High-tech adjuncts to emergency weight estimation: Point-of-care ultrasound and point-of-care bioelectrical impedance measurements can increase the accuracy of length-based weight estimation in children

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