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MANAGING PEDIATRIC RESUSCITATION requires precision, skill, and a systematic approach. During the development of simulation-based courses designed to improve pediatric patient safety, several clinical discussions emerged concerning the use of the Broselow tape. Many pediatric emergency medicine physicians providing frequent pediatric resuscitations may recognize the Broselow tape as a reliable and easy-to-follow guide for estimating medication dosage and tool size. However, not all practitioners feel this way.

1. Free Broselow Tape Download

Free Broselow Tape Download

The Broselow Tape and associated system The Broselow Tape, also called the Broselow pediatric emergency tape, is a color-coded length-based tape measure that is used throughout the world for pediatric emergencies. The Broselow Tape relates a child’s to provide medical instructions including medication, the size of the that should be used, and the level of shock when using a. Particular to children is the need to calculate all these therapies for each child individually. In an emergency the time required to do this detracts from valuable time needed to evaluate, initiate, and monitor patient treatment. The Broselow Tape is designed for children up to approximately 12 years of age who have a maximum weight of roughly 36 kg (80 pounds). The Broselow Tape is recognized in most medical textbooks and publications as a standard for the emergency treatment of children. Color coded equipment drawers based on the Broselow Tape To use the Broselow Tape effectively the child must be lying down.

Use one hand to hold the red end of the tape so it is even with the child’s head. (Remember: “red to head”). While maintaining one hand on the red portion at the top of the child’s head, use your free hand to run the tape down the length of the child’s body until it is even with his/her heels (not toes).

The tape that is level with the child’s heels will provide his/her approximate weight in kilograms and his/her color zone. As the tape is not completely accurate, care is required with its use. Accuracy The Broselow Tape is based on the relationship between weight and length across all ages; each color zone estimates the 50th weight for length, which for practical purposes estimates the for emergency dosing. Because of the recent, concerns have been raised as to the accuracy of the tape to determine acceptable weights and subsequently acceptable doses of emergency medications. The most recent version of the Broselow Tape incorporates updated length/weight zones based on the most current data set. Utilizing this data set to examine Broselow Tape predictions of actual body weight with the revised zones reveals that approximately 65% of the time the patient’s measured length places them in the correct zone for actual weight.

Of the remaining 35%, 20% fall into the heavier Broselow-Luten zone above and 13% fall into the lighter zone below, with. # Measure child to identify weight/color zone.

If a child appears overweight consider utilizing one zone higher for dosing only. Always use the tape measured length zone for equipment selection regardless of body habitus.

Multiple studies have been conducted regarding the effectiveness of the Broselow Tape. Recently, in 2012, a study with 572 enrolled subjects published that paramedic Broselow measurements correlated well with both scale and ED measurements, underscoring its utility in the prehospital setting. In spite of the debates about accuracy in actual weight estimation and its relevance as noted above, the tape still remains the best tool for predicting actual body weight. Design The original Broselow tape was divided into 25 kg zones for medication doses and eight color zones for equipment selection. Subsequent versions of the tape combined dosing and equipment zones such that the eight color zones contained both dosing and equipment information, thus creating a simple visual system for medication and equipment which is used in most hospitals and ambulances. The following list identifies which color zones correlate with each estimated weight zone in kilograms (kg) and pounds (lbs).

Color Estimated Weight (in kilograms) Estimated Weight (in pounds) Grey 3–5 kg 6-11 lbs Pink 6–7 kg 13-15 lbs Red 8–9 kg 17-20 lbs Purple 10–11 kg 22-24 lbs Yellow 12–14 kg 26-30 lbs White 15–18 kg 33-40 lbs Blue 19–23 kg 42-50 lbs Orange 24–29 kg 53-64 lbs Green 30–36 kg 66-80 lbs History Emergency physicians and Robert Luten struggled with solving these issues related to the emergency treatment of children in the early 1980s. The result was the invention by Dr.

Broselow of a home-made prototype version of the tape in 1985. Broselow joined with Dr. Luten, an academic physician from the and member of the newly formed subcommittee, to do the foundational studies upon which the tape was based and to develop and update the tape over the years. The tape provides pre-calculated medication doses effectively eliminating the potential errors associated with pediatric emergent dosing preparation and administration. This benefit has had major implications in recent years given the prevalence and magnitude of medication errors. Are a greater threat to children than adults because their organs are smaller and still developing. An estimated 35% of pediatric patients are incorrectly dosed by EMS providers.

Tenfold mathematical errors due to incorrect calculations are a much greater threat to children than adults. Due to the high level of incorrect calculation errors, alternative that can be customized have gained popularity.

A tenfold adult overdose of a standard adult medication would require multiple and tends, therefore, to be obvious to a caregiver, effectively warning of the error. In contrast, for a small child both a 1x correct dose and a 10x can be administered in the same syringe thus providing no clue as to a potential error. Furthermore, pediatric emergency care is especially prone to error due to the chaotic nature and stress associated with the emergency setting. References.