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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; [email protected]

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

References

REFERENCES

1.ECC Committee, Subcommittees and Task Forces of the American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2005;112 (24 Suppl):167–88.Google Scholar
2.Hofer, CK, Ganter, M, Tucci, M, et al. How reliable is length-based determination of body weight and tracheal tube size in the paediatric age group? The Broselow tapereconsidered. Br J Anaesth 2002;88:283–5, doi:10.1093/bja/88.2.283.Google Scholar
3.Lubitz, DS, Seidel, JS, Chameides, L, et al. A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group. Ann Emerg Med 1988;17:576–81, doi:10.1016/S0196-0644(88)80396-2.Google Scholar
4.Luten, RC, Wears, RL, Broselow, J, et al. Length-based endotracheal tube and emergency equipment in pediatrics [published erratum appears in Ann Emerg Med 1993;22:155]. Ann Emerg Med 1992;21:900–4, doi:10.1016/S0196-0644(05)82924-5.CrossRefGoogle ScholarPubMed
5.World Health Organization, Obesity: preventing and managing the global epidemic. Geneva: World Health Organization; 2000, Technical Report Series #894.Google Scholar
6.Sokol, RJ. The chronic disease of childhood obesity: the sleeping giant has awakened. J Pediatr 2000;136:711–3, doi:10.1067/mpd.2000.107787.Google Scholar
7.Tremblay, MS, Katzmarzyk, PT, Willms, JD. Temporal trends in overweight and obesity in Canada, 1981-1996. Int J Obes Relat Metab Disord 2002;26:538–43.CrossRefGoogle ScholarPubMed
8.Canning, PM, Courage, ML, Frizzell, LM. Prevalence of overweight and obesity in a provincial population of Canadian preschool children. CMAJ 2004;171:240–2, doi:10.1503/cmaj.1040075.Google Scholar
9.He, M, Sutton, J. Using routine growth monitoring data in tracking overweight prevalence in young children. Can J Public Health 2004;95:419–23.CrossRefGoogle ScholarPubMed
10.Veugelers, PJ, Fitzgerald, AL. Prevalence of and risk factors for childhood overweight and obesity. CMAJ 2005;173:607–13, doi:10.1503/cmaj.050445.CrossRefGoogle ScholarPubMed
11.Tjepkema, M. Measured obesity. Adult obesity in Canada: measured height and weight. Ottawa: Statistics Canada; Statistics Canada Cat, No. 82-620-MWE2005001.Google Scholar
12.He, M, Beynon, C. Prevalence of overweight and obesity in school-aged children. Can J Diet Pract Res 2006;67:125–9, doi:10.3148/67.3.2006.125.CrossRefGoogle ScholarPubMed
13.Black, K, Barnett, P, Wolfe, R, et al. Are methods used to estimate weight in children accurate? Emerg Med (Fremantle) 2002;14:160–5, doi:10.1046/j.1442-2026.2002.00311.x.CrossRefGoogle ScholarPubMed
14.Varghese, A, Vasudevan, VK, Lewin, S, et al. Do length-based BT, APLS, Argall and Nelson’s formulae accurately estimate weight of Indian children? Indian Pediatr 2006;43:889–94.Google Scholar
15.Jang, HY, Shin, SD, Kwak, YH. Can the Broselow tape be used to estimate weight and endotracheal tube size in Korean children? Acad Emerg Med 2007;14:489–91.CrossRefGoogle ScholarPubMed
16.Anstett, D, Bawden, J, Moylette, E, et al. Does the Broselow Tape accurately estimate the weight of healthy Irish children? Presented at the Canadian Association of Emergency Physician Annual Meeting; 2009 June; Calgary, AB.Google Scholar
17.National Center for Health Statistics. 2000 CDC growth charts: United States. Available at: http://www.cdc.gov/growthcharts/ (accessed July 29, 2006).Google Scholar
18.Theron, L, Adams, A, Jansen, K, et al. Emergency weight estimation in Pacific Island and Maori children who are large-for-age. Emerg Med Australas 2005;17:238–43, doi:10.1111/j.1742-6723.2005.00729.x.Google Scholar
19.Knight, J, Lubell, R, Milne, WK. Does the Broselow Tape accurately estimate the weight of Canadian children? Presented at the Canadian Association of Emergency Physician Annual Meeting; 2008 June; Ottawa, ON.Google Scholar
20.Selbst, SM, Fein, JA, Osterhoudt, K, et al. Medication errors in a pediatric emergency department. Pediatr Emerg Care 1999;15:1–4, doi:10.1097/00006565-199902000-00001.CrossRefGoogle Scholar
21.Yamamoto, LG, Inaba, AS, Young, LL, et al. Improving length-based weight estimates by adding a body habitus (obesity) icon. Am J Emerg Med 2009;27:810–5, doi:10.1016/j.ajem.2008.06.023.CrossRefGoogle ScholarPubMed
22.Improving the health of Canadians: prompting healthy weights. Canadian Population Health Initiative. Canadian Institute for Health Information. 2006. Ottawa, Canada. Available at: http://secure.cihi.ca/cihiweb/products/healthyweights06_e.pdf (accessed March 26, 2011).Google Scholar
23.Filler, G, Yasin, A, Kesarwani, P, et al. Big mother or small baby: which predicts hypertension? J Clin Hypertens. Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1751-7176.2010.00366.x/pdf (accessed August 20, 2010).Google Scholar