Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-23T11:10:09.120Z Has data issue: false hasContentIssue false
  • English
  • Français

The Broselow and Handtevy Resuscitation Tapes: A Comparison of the Performance of Pediatric Weight Prediction

Published online by Cambridge University Press:  25 May 2016

Calvin G. Lowe ,
Rashida T. Campwala ,
Nurit Ziv  and
Vincent J. Wang
Calvin G. Lowe*
Affiliation:
Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CaliforniaUSA Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, CaliforniaUSA
Rashida T. Campwala
Affiliation:
Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CaliforniaUSA
Nurit Ziv
Affiliation:
Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CaliforniaUSA
Vincent J. Wang
Affiliation:
Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CaliforniaUSA Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, CaliforniaUSA
*
Correspondence: Calvin G. Lowe, MD Division of Emergency and Transport Medicine Children’s Hospital Los Angeles 4650 Sunset Blvd., Mailstop #113 Los Angeles, California 90027 USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

To assess the performance of two pediatric length-based tapes (Broselow and Handtevy) in predicting actual weights of US children.

Methods

In this descriptive study, weights and lengths of children (newborn through 13 years of age) were extracted from the 2009-2010 National Health and Nutrition Examination Survey (NHANES). Using the measured length ranges for each tape and the NHANES-extracted length data, every case from the study sample was coded into Broselow and Handtevy zones. Mean weights were calculated for each zone and compared to the predicted Broselow and Handtevy weights using measures of bias, precision, and accuracy. A sub-sample was examined that excluded cases with body mass index (BMI)≥95th percentile. Weights of children longer than each tape also were examined.

Results

A total of 3,018 cases from the NHANES database met criteria. Although both tapes underestimated children’s weight, the Broselow tape outperformed the Handtevy tape across most length ranges in measures of bias, precision, and accuracy of predicted weights relative to actual weights. Accuracy was higher in the Broselow tape for shorter children and in the Handtevy tape for taller children. Among the sub-sample with cases of BMI≥95th percentile removed, performance of the Handtevy tape improved, yet the Broselow tape still performed better. When assessing the weights of children who were longer than either tape, the actual mean weights did not approximate adult weights; although, those exceeding the Handtevy tape were closer.

Conclusions

For pediatric weight estimation, the Broselow tape performed better overall than the Handtevy tape and more closely approximated actual weight.

LoweCG, CampwalaRT, ZivN, WangVJ. The Broselow and Handtevy Resuscitation Tapes: A Comparison of the Performance of Pediatric Weight Prediction. Prehosp Disaster Med. 2016;31(4):364–375.

Keywords

body weights and measuresemergency treatmentpediatricsprehospital care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 4 , August 2016 , pp. 364 - 375
Copyright
© World Association for Disaster and Emergency Medicine 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Emergency Medical Services Authority and California Health and Human Services Agency. Guidelines for Prehospital Pediatric Protocol. State of California; 2011.Google Scholar
2. Institute of Medicine Committee on the Future of Emergency Care in the USHS. The future of emergency care in the United States health system. Ann Emer Med. 2006;48(2):115-120.CrossRefGoogle Scholar
3. Abdel-Rahman, SM, Ridge, A, Kearns, GL. Estimation of body weight in children in the absence of scales: a necessary measurement to insure accurate drug dosing. Arch Dis Child. 2014;99(6):570-574.CrossRefGoogle Scholar
4. Kleinman, ME, de Caen, AR, Chameides, L, et al. Pediatric basic and advanced life support: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Pediatrics. 2010;126(5):e1261-e1318.CrossRefGoogle ScholarPubMed
5. Lubitz, DS, Seidel, JS, Chameides, L, Luten, RC, Zaritsky, AL, Campbell, FW. A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group. Ann Emer Med. 1988;17(6):576-581.CrossRefGoogle ScholarPubMed
6. Rosenberg, M, Greenberger, S, Rawal, A, Latimer-Pierson, J, Thundiyil, J. Comparison of Broselow tape measurements versus physician estimations of pediatric weights. Am J Emerg Med. 2011;29(5):482-488.CrossRefGoogle ScholarPubMed
7. Krieser, D, Nguyen, K, Kerr, D, Jolley, D, Clooney, M, Kelly, AM. Parental weight estimation of their child’s weight is more accurate than other weight estimation methods for determining children’s weight in an emergency department? Emerg Med J. 2007;24(11):756-759.CrossRefGoogle ScholarPubMed
8. So, TY, Farrington, E, Absher, RK. Evaluation of the accuracy of different methods used to estimate weights in the pediatric population. Pediatrics. 2009;123(6):e1045-e1051.CrossRefGoogle ScholarPubMed
9. Wells, M, Coovadia, A, Kramer, E, Goldstein, L. The PAWPER tape: a new concept tape-based device that increases the accuracy of weight estimation in children through the inclusion of a modifier based on body habitus. Resuscitation. 2013;84(2):227-232.CrossRefGoogle Scholar
10. Armstrong Medical Industries. Broselow Pediatric Emergency Tape; 2011. https://www.armstrongmedical.com/index.cfm/go/product.detail/sec/3/ssec/14/fam/2371. Accessed May 2, 2013.Google Scholar
11. Cattermole, GN, Leung, PY, Graham, CA, Rainer, TH. Too tall for the tape: the weight of schoolchildren who do not fit the Broselow tape. Emerg Med J. 2013; [epub ahead of print].Google Scholar
12. Antevy, P. First-hand approach. A novel method to rapidly calculate pediatric drug dosages. JEMS. 2013;38(8):32-35.Google ScholarPubMed
13. National Health and Nutrition Examination Survey, 2009-2010. http://wwwn.cdc.gov/nchs/nhanes/search/nhanes09_10.aspx. Accessed May 5, 2013.Google Scholar
14. National Health and Nutrition Examination Survey Anthropometry Procedures Manual 2009. http://www.cdc.gov/nchs/data/nhanes/nhanes_09_10/BodyMeasures_09.pdf. Accessed May 14, 2013.Google Scholar
15. Pediatric Emergency Standards; Handtevy PreHospital 2014. www.handtevy.com. Accessed May 31, 2013.Google Scholar
16. Centers for Disease Control and Prevention. Growth Charts, 2013. http://www.cdc.gov/growthcharts. Accessed May 31, 2013.Google Scholar
17. Centers for Disease Control and Prevention. Basics About Childhood Obesity 2013. http://www.cdc.gov/obesity/childhood/basics.html. Accessed May 2, 2013.Google Scholar
18. Annis, C. Statistical Engineering: Precision Bias. http://www.statisticalengineering.com/ Weibull/precision-bias.html. Accessed March 15, 2013.Google Scholar
19. Ackwerh, R, Lehrian, L, Nafiu, OO. Assessing the accuracy of common pediatric age-based weight estimation formulae. Anesth Analg. 2014;118(5):1027-1033.CrossRefGoogle ScholarPubMed
20. Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-310.CrossRefGoogle ScholarPubMed
21. Abdel-Rahman, SM, Paul, IM, James, LP, Lewandowski, A, Best Pharmaceuticals for Children Act-Pediatric Trials N. Evaluation of the Mercy TAPE: performance against the standard for pediatric weight estimation. Ann Emerg Med. 2013;62(4):332-339; e336.CrossRefGoogle ScholarPubMed
22. Hanneman, SK. Design, analysis, and interpretation of method-comparison studies. AACN. 2008;19(2):223-234.Google ScholarPubMed
23. Mantha, S, Roizen, MF, Fleisher, LA, Thisted, R, Foss, J. Comparing methods of clinical measurement: reporting standards for bland and altman analysis. Anesth Analg. 2000;90(3):593-602.CrossRefGoogle ScholarPubMed
24. Centers for Disease Control and Prevention. Child Obesity Facts: Prevalence of Childhood Obesity in the United States, 2011-2012. http://www.cdc.gov/healthyyouth/obesity/facts.htm. Accessed June 13, 2013.Google Scholar
25. Sandell, JM, Charman, SC. Can age-based estimates of weight be safely used when resuscitating children? Emerg Med J. 2009;26(1):43-47.CrossRefGoogle ScholarPubMed
Supplementary material: Image

Lowe supplementary material

Figure

Download Lowe supplementary material(Image)
Image 486.9 KB