Weighing the pediatric patient during trauma resuscitation and its concordance with estimated weight using Broselow Luten Emergency Tape.
ABSTRACT Obtaining an accurate weight is crucial during pediatric trauma/medical resuscitation. Currently, length-based weight estimations are used. Study objective was to assess feasibility of obtaining actual weights of children during trauma resuscitation and study its concordance with length-based estimated weight using the Broselow Pediatric Emergency Tape.
Pediatric trauma patients 0 to 14 years old presenting to a tertiary care pediatric trauma center between November 2008 and October 2009 were enrolled prospectively. Length-based weight estimation was done on patient arrival using the Broselow tape; in addition, an actual patient weight was recorded using the trauma stretcher integrated weighing scale.
Two hundred thirty-one patients were eligible and enrolled. Weights were recorded in 145 children (63.2%). In 27 patients (18.6%) whose body length exceeded Broselow tape range, weight was measured using stretcher scale only. The remaining 118 patients (mean age, 5.0 [SE ± 0.3] years; 67% male) were used for correlation analysis. There was good correlation (Pearson correlation coefficient, r = 0.86) between estimated weight and measured weight. However, Bland-Altman analysis showed mean bias +2.6 kg (95% confidence interval [CI], 1.6-3.6 kg); lower/upper limits of agreement were -8.3 kg (CI, -10.0 to -6.6 kg) and 13.5 kg (CI, 11.7-15.2 kg).
It is possible to obtain an actual patient weight during pediatric trauma resuscitation. Length-based estimated weight using Broselow tape underestimated weight by 2.6 kg; the mean error was greatest in the highest weight category.
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ABSTRACT: The purpose of this study was to determine the concordance of the Broselow tape with the measured heights and weights of a community-based population of children, especially in light of the increase in obesity in today's children. The authors examined more than 7,500 children in a cross-sectional, descriptive study in two different cohorts of children to compare their actual weight with their predicted weight by a color-coded tape measure. In all patients, the percent agreement and kappa values of the Broselow color predicted by height versus the actual color by weight for the 2002A tape were 66.2% and 0.61, respectively. The concordance was best in infants, followed by school-age children, toddlers, and preschoolers (kappa = 0.66, 0.44, 0.39, and 0.39, respectively; percent agreement, 81.3%, 58.2%, 60.7%, and 64.0%, respectively). The tapes accurately predicted (within 10%) medication dosages for resuscitation in 55.3%-60.0% of the children. The number of children who were underdosed (by > or =10%) exceeded those who were overdosed (by > or =10%) by 2.5 to 4.4 times (p < 0.05). The tapes accurately predicted uncuffed endotracheal tube sizes when compared with age-based guidelines in 71% of the children, with undersizing (> or =0.5 mm) exceeding oversizing by threefold to fourfold (p < 0.05). The Broselow tape color-coded system inaccurately predicted actual weight in one third of children. Caregivers need to take into consideration the accuracy of this device when estimating children's weight during the resuscitation of a child.Academic Emergency Medicine 10/2006; 13(10):1011-9. · 1.76 Impact Factor
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ABSTRACT: To evaluate differences in accuracy of 2 weight estimation methods for children when compared with measured weights: the Broselow-Luten tape (patient's height as the predictor) and the devised weight estimation method (DWEM) (patient's height and body habitus as predictors). Information was obtained prospectively on a convenience sample of patients presenting through triage on nonconsecutive days at the Children's Hospital Emergency Department. Weight was measured in kilograms, and a measured length or height in centimeters was obtained, as well as 2 independent assessments of body habitus. Weights were then estimated using the Broselow-Luten tape and the DWEM. This study evaluated 4 separate weight classes: less than or equal to 10 kg, 10.1 to 20 kg, 20.1 to 36 kg, and 36.1 kg or more. One hundred children were recruited into each weight class, for a total of 400 children. Comparisons of estimations with measured weights were made using the Pearson correlation coefficient method. Mean percentage errors were calculated for weight estimations by both methods. Both the Broselow-Luten and DWEM weight estimations when compared with measured weights showed statistical correlation (using the Pearson correlation coefficient). However, the Broselow-Luten method had a negative mean percentage error in all weight classes, and the DWEM had a negative mean percentage error in classes greater than 20 kg, indicating an underestimation of weight in those classes. Although both the Broselow-Luten and DWEM weight estimations show statistical correlation with measured weights, the Broselow-Luten method underestimates weights in all weight classes, and the DWEM underestimates weights in the weight classes greater than 20 kg.Pediatric emergency care 05/2007; 23(4):227-30. · 0.92 Impact Factor
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ABSTRACT: Length-based dosing systems reduce errors associated with resuscitation drug dosing. Obese and thin children of the same length are dosed the same despite their different weights. Length (height) and weight were measured in children after a body habitus icon assignment. Within each body habitus group, regression analysis was performed to generate a weight-estimation formula using body habitus and length (BHL). This BHL method was compared to the Broselow tape (BT). Height and weight data were plotted to obtain visual scattergrams. Logarithmic regression yielded higher correlation coefficients than standard linear regression. Within body habitus groups, BHL epinephrine dose estimates were more accurate than BT dose estimates using 0.01 mg/kg as a dosing standard. Adding body habitus information to the patient's length results in a more accurate weight estimate than length alone in children. The accuracy improvement is greater in children 3 years and older as compared to younger children.The American journal of emergency medicine 10/2009; 27(7):810-5. · 1.54 Impact Factor