In a simulated pediatric emergency, color coding significantly reduced the deviation from recommended doses. The pre-calculated dosing in the Broselow tape facilitates rapid weight estimation, saves time by providing corresponding drug dosing, and alleviates stress during pediatric resuscitation. In a critical life-threatening condition, it is not judicious to consume the valuable time needed to evaluate, initiate, and monitor patient treatment to calculate the estimated weight, the equipment sizes, and the drug doses. It is recognized in most medical textbooks and publications as a standard for the emergency treatment of children and is recommended by the Advanced Trauma Life Support and Pediatric Advanced Life Support. The Broselow tape also provides medical instructions including the medication dosages, the size of the equipment, and the level of shock voltage when using a defibrillator. The Broselow pediatric emergency tape is a color-coded length-based tape measure that was developed using height/weight correlations for children who have a maximum weight of roughly 36 kg from a nationally representative sample of children in the USA. Length-based weight estimation is developed as a different alternative to estimate the weight. Wrong estimation of weight or incorrect calculation of drug dosage or equipment size could result in grave consequences. When the accurate weight of the child cannot be obtained, it is usually calculated using an age-based formula such as advanced pediatric life support (APLS) formula which can be incorrect and time-consuming. It is not always feasible to measure the weight of a child using the standard weighing machine in the ED where the condition is critical and immediate action is required. Incorrect estimation of patient weight, leading to incorrect drug dosing, is one of the most frequently reported errors. The medical error related to the calculation of pediatric medication dosage is very high. In contrast to adults, the pediatric emergency drug dose, equipment sizes, and defibrillation energy doses are calculated based on the weight of the individual child and are a challenge for the treating emergency physician. The accurate measurement or estimation of the weight of a child is crucial for the effective and optimal acute management of pediatric emergencies. Hence, PALS age-based formula for ET tube size estimation and weight-based formula for adrenaline dose calculation are recommended for children weighing more than 18 kg.Ĭhildren with a wide variety of urgent medical and surgical conditions visit the emergency department (ED), which requires immediate life-saving intervention and resuscitation. The Broselow tape should be avoided in children weighing more than 18 kg. The accuracy of the Broselow tape in estimating the weight of a child, endotracheal tube size, and dose of adrenaline is higher in weight group of less than 18 kg, and accuracy decreases as the weight of child increases. The estimated size of the endotracheal tube ( p = 0.01) and adrenaline dose ( p = 0.08) by the Broselow tape was in agreement with that estimated using PALS formula in weight group of less than 18 kg, but decreases as the estimated weight increases further. The precision of the tape was relatively high in the lower length zones as compared to the higher length zones. Our analysis showed that the accuracy of estimated weight with the Broselow tape decreases with increasing weight of children. There was a positive relationship between the actual body weight and the estimated body weight (correlation ( r = 0.970, p = 0.01) and accuracy ( r 2 = 0.941)). There was a total agreement of the estimated color zone according to the Broselow tape with the actual weight in the gray zone ( p = 0.01). They were divided into 3 groups according to their estimated weight by the Broselow tape into 18 kg. This study included 315 children with male to female ratio of 0.63:1. The errors in the selection of endotracheal tube size and adrenaline dose using the Broselow tape were also explored. Our study aims to prospectively compare the actual weights of urban and rural Nepalese children with the estimated weights using the Broselow tape (2017 edition) and the updated APLS formula. This study was conducted in the Department of Pediatrics of Dhulikhel Hospital, Kathmandu University Teaching Hospital, in children less than 15 years of age. However, in low-income countries like Nepal, due to factors like undernutrition, the Broselow tape may not accurately estimate weight in all ranges of pediatric age group. Broselow tape is a color-coded length-based tape that utilizes height/weight correlations for children. Unlike adults, the pediatric emergency drug dose, equipment sizes, and defibrillation energy doses are calculated based on the weight of the individual child. Children with emergency conditions require immediate life-saving intervention and resuscitation.
0 kommentar(er)
