The use of the Broselow tape has been the subject of several studies to validate its use. The tape is recommended by the Advanced Trauma Life Support (ATLS) and the Pediatric Advanced Life Support in the USA and Europe. The color zones are designed to predict the 50th percentile weight for height, which is an estimate of ideal body mass. Its predicted weight ranges are derived from pediatric anthropometric data collected by the National Center for Health Statistics (NCHS) between 1963–1975. The Broselow tape correlates measured heights ranging between 46–146.5 cm to predicted weight ranges between 3–36 kg, arranged in color zones. Pediatric medication dosing has been recognized as a high-error activity with the potential to cause serious harm, and it has been found that the Broselow tape and color-coded materials would result in a decrease in deviation from recommended medication doses and equipment sizes and an increase in physician comfort level. A recent study has provided us with compelling evidence that methods based on the length of the child are more accurate than age-based formulae. The Broselow tape is recommended by the Indian Academy of Pediatrics. The new APLS guidelines include three new formulae that stratify the pediatric population using the original APLS for ages 1–5 years and Luscombe and Owens formulae for ages 6–12 years. Ī comparative study on the Luscombe and Owens new formula and the most recent new APLS formulae has not been conducted in India. Evidence shows that the APLS formula tend to underestimate the actual weight and the margin of error increases with age. However, recent studies in India indicate that such method may be erroneous.Ī comparison of age-derived methods with length-based estimation of weights has demonstrated that the Broselow tape can predict dosages of resuscitation drugs with better accuracy. In India, the age-derived weight methods using the Nelson formula or APLS in pediatrics is often used. The Broselow tape was developed for use in the USA to overcome such impracticalities. Manual dose calculation using dosing equations during pediatric treatment also proved to be a high-error activity. Recent studies provide ample evidence on dosing errors in pediatric emergency settings with concomitant large percentage of adverse events (AE). The Broselow tape is deemed a practical tool that facilitates a fast weight estimation in emergency settings and may help to circumvent dosing errors. The Indian children are underweight for their age and height. In its current format, however, the Broselow tape cannot be utilized with optimal accuracy. Emergency medicine is an emerging field in India and an age-based weight estimation in the pediatic population during emergency intervention is more prone to dosing errors. The need for the use of the Broselow tape as a length-based weight estimation tool in India is two-fold. ConclusionsĪ remodeled Broselow tape can predict weights with higher accuracy in the Indian pediatric population. The new Indian pediatric weight estimation tool (IPWET), based on the Broselow tape has a weight range of 4–36 kg and height range of 50–150 cm (Broselow tape, 3–36 kg, 46–146.5 cm) and an improved accuracy between 51–97.8 %. Accuracy of the Broselow tape by color-coded zone was between 33–86.6 %, with higher weight color zones showing lower accuracy. The Broselow tape overestimates weights with a mean percentage difference of 5–15 % depending on the color zone. In the second stage, we recruited 416 children and tested the new ranges for accuracy. With univariate linear regression, we adjusted the Broselow tape by an 8 % correction factor to enhance accuracy and created a new tape with new weight and height ranges. In the first stage, we recruited 769 children. The Broselow tape was used for length-based weight estimation, and actual weight was recorded by a weighing scale. We prospectively collected cross-sectional data on a sample of 1185 children aged 1 month to 12 years old in Chennai, India. The Broselow tape overestimates the heights of the Indian pediatric population and remits inaccurate predicted weights for all color zones with varying degrees and could result in overresuscitation of Indian children in emergency settings. This study aims to remodel the Broselow Pediatric Emergency Tape for the Indian pediatric population.
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