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Ontario children have outgrown the Broselow tape

Published online by Cambridge University Press:  11 May 2015

William Ken Milne ,
Abeer Yasin ,
Janine Knight ,
Daniel Noel ,
Richard Lubell  and
Guido Filler
William Ken Milne
Affiliation:
Division of Emergency Medicine, University of Western Ontario, London, ON
Abeer Yasin
Affiliation:
Department of Pediatrics, University of Western Ontario, London, ON
Janine Knight
Affiliation:
Faculty of Medicine, University of Ottawa, Ottawa, ON
Daniel Noel
Affiliation:
Maitland Valley Medical Centre, Goderich, ON
Richard Lubell
Affiliation:
Department of Pediatrics, University of Western Ontario, London, ON
Guido Filler*
Affiliation:
Department of Pediatrics, University of Western Ontario, London, ON
*
Department of Paediatrics, University of Western Ontario, 800 Commissioners Road East, London, ON N6A 5W9; guido.filler@lhsc.on.ca

Abstract

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Objective:

The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a well-established length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort.

Methods:

Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated.

Results:

A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r = 0.95577, p < 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% ± 16.9% SD, 95% CI -26.0-40.2). The BT had an ≥ 10% PE 43.7% of the time.

Conclusions:

Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy.

Keywords

Broselow Pediatric Emergency TapeCanadianobesitypediatricsresuscitation
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 1 , January 2012 , pp. 25 - 30
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

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