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. RJ Frascone.In contrast to adults, drugs are administered to infants and children on the basis of actual weight or surface area. From 2010-2011 I completed a prehospital medicine/EMS fellowship under the medical direction of Dr.
Paul where I had the privilege to serve as chief resident in 2009. Residency training in Emergency Medicine brought me to Regions Hospital in St. For medical school I returned to NY and completed my MD degree at SUNY Upstate Medical University in Syracuse, NY. During undergrad I transferred my certification to Massachusetts and was employed by several private EMS agencies over the next 4 years. I earned my EMT at 18 while I was employed by the Vestal Volunteer Emergency Squad as a BLS crew chief. My career in medicine started with my certified first responder-defibrillation (CFR-D) certification by NYS at age 16. I am a practicing Emergency Physician and the Assistant Medicl Director for Regions Hospital EMS in St. We host an EMS fellowship and are affiliated with Regions Hospital EM residency. Regions EMS is an academic department providing medical direction to over 1500 prehospital provders. There are now LMA sizes for each color listed. Green- Nasopharyngeal airway is now -26 FR The major changes are with drug dosing and alittle different estimate of weights for our ‘growing’ pediatric population. The new 2011 Braselow tape has now been released. Once the new tape is considered the reference we may want to consider to having the medics change the equipment to make it match the tape. The tape does recommend some changes in equipment. Equipment is done by ideal weight, so it is reccamended to still use the measured size for the child for equipment selection. There is a reccomendation that if you have an obese child to consider going up in size for medications. The sizing and placement of the colors have changed to go along with the increased weight of kids. I think using it as is for reference is fine. The biggest I see is the change from 15mg/kg/dose to 20 mg/kg/dose for Fosphenytoin and Phenytoin. Other changes include some small changes in medications. It has the new dosing for defibrillation that go along with the new AHA guidelines. The new Braselow tape has now been released.
Broselow tape 2017 changes update#
Regions Hospital Emergency Medical Services Critical Care Education Specialist gives us an update on the recently released 2012 Braselow tape.
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