This study showed a consistent overestimate of the weight by the Broselow tape with a 10 per cent or more overestimation in children with >10 kg with an overall line of regression y=1.076x+0.27. Sample size: The sample size calculations were based on the study conducted by Ramarajan et al 15. The tape that is level with the child's heels provided the child's approximate weight (kg) and the colour zone 14. While maintaining the position of the hand on the red portion at the top of the child's head, the free hand was used to run the tape down the length of the child's body until it was even with the child's heels. Usage of Broselow tape: To use the Broselow tape effectively, the child was made to lie down. Using the age provided by the caregiver, the child's weight was calculated using the APLS and updated APLS formulae 5, 6, 7. The data were recorded in a pre-designed proforma. For each child, the tape's colour code system was noted and compared. Each colour zone has dosages of emergency and premedication drugs, paralytic and induction agents and defibrillation written for children of corresponding estimated weights. The Broselow tape ® (Armstrong Medical Industries, Lincolnshire, IL, USA) used for the estimation of weight based on the length has colour-coded segments depending on the weight estimated on the basis of length: grey (3-5 kg), pink (6-7 kg), red (8-9 kg), purple (10-11 kg), yellow (12-14 kg), white (15-18 kg), blue (19-22 kg), orange (24-28 kg) and green (30-36 kg). The weight of children was measured to the nearest 0.1 kg using an electronic weighing scale (IPA Devices Pvt. Age was determined based on documentary evidence or on the basis of birth date, birth year or age stated by the care-giver. Children were excluded from the study if they required immediate or emergency management or weighed over 35 kg or had height exceeding 145 cm.ĭemographic data were collected from the parents or guardians. If the prospective research participant was over seven years of age, his/her assent was also obtained before enrolment. The study was initiated after obtaining ethical approval from the Institutional Ethics Committee and children aged 12-144 months were enrolled in the study after obtaining written informed consent from parents. This cross-sectional study was carried out at the Paediatric Outpatient and Inpatient departments of BYL Nair ChariTable Hospital, a tertiary care public hospital attached to TN Medical College in Mumbai, India, over a period of 18 months from April 2012. The findings of Broselow tape were compared with those obtained using APLS and updated APLS formulae. Hence, this study was undertaken to determine the accuracy of weight measured by Broselow tape and compare it with the actual weight of Indian children. Although the Broselow tape has been validated in both ambulatory 9, 10, 11, 12 and simulated emergency situations 13 in the United States and is believed to reduce complications arising from inaccurate drug dosing and equipment sizing, but given the prevalence of malnutrition and consequent aberration in growth in Indian children it may overestimate the weight of these children. The Broselow tape recommends dosages of emergency drugs and preferred equipment sizes, on the basis of predicted weight, which, in turn, is estimated on the basis of actual height (height-weight correlation). The Indian Academy of Pediatrics supported Paediatric Advanced Life Support Programme recommends that Broselow tape is used in such circumstances 8. It can also be predicted using age-based formulae such as advanced paediatric life support (APLS) formula or updated APLS formula 5, 6, 7. In such situations, various methods are used to determine the drug dosages and sizes of equipment: ‘guesstimates’ based on the child's apparent size or stature 1, predicting it on the basis of length 2, foot length 3, age 4 or a combination of above 4. In addition, when children present with shock or respiratory arrest or circulatory collapse, it may be necessary to carry out endotracheal intubation straight away. There is hardly any time to determine weight or height and calculate dosages of emergency drugs. When children present in a critical state, the caregivers are expected to provide instant care and administer drugs immediately. In contrast to adults, drugs are administered to infants and children on the basis of actual weight or surface area.
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