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Published on: February 2, 2017
An Indian pediatric emergency weight estimation tool: prospective adjustment of the Broselow tape
Farhad Asskaryar1, Ravi Shankar
1Department of Community Medicine, Sri Ramachandra University, College of Medicine & Research Institute, Porur, Chennai, 600116, Tamil Nadu, India, fasskaryar@gmail.com.
Insights
The Broselow tape inaccurately estimates weight in Indian children. A modified tape, the Indian Pediatric Weight Estimation Tool (IPWET), improves accuracy for emergency pediatric care in India.
Area of Science:
- Pediatric Emergency Medicine
- Medical Device Adaptation
- Biometrics and Anthropometry
Background:
- The Broselow tape, a length-based resuscitation tool, overestimates weight in Indian children.
- This inaccuracy can lead to medication and fluid overresuscitation in emergency settings.
- Indian children tend to be underweight for their age and height.
Purpose of the Study:
- To remodel the Broselow Pediatric Emergency Tape for the Indian pediatric population.
- To enhance the accuracy of weight estimation for Indian children in emergencies.
Main Methods:
- Collected cross-sectional data from 1185 Indian children (1 month to 12 years).
- Used univariate linear regression with an 8% correction factor to adjust the Broselow tape.
- Developed and tested a new weight and height range for the adapted tape.
Main Results:
- The original Broselow tape showed 5-15% weight overestimation and 33-86.6% accuracy.
- The new Indian Pediatric Weight Estimation Tool (IPWET) covers 4-36 kg and 50-150 cm.
- IPWET achieved improved accuracy ranging from 51-97.8%.
Conclusions:
- A remodeled Broselow tape, the IPWET, significantly improves weight prediction accuracy for Indian children.
- This adaptation is crucial for safe and effective emergency pediatric care in India.
Background:
This study aims to remodel the Broselow Pediatric Emergency Tape for the Indian pediatric population. The Broselow tape overestimates the heights of the Indian pediatric population and remits inaccurate predicted weights for all color zones with varying degrees and could result in overresuscitation of Indian children in emergency settings. The Indian children are underweight for their age and height.
Methods:
We prospectively collected cross-sectional data on a sample of 1185 children aged 1 month to 12 years old in Chennai, India. The Broselow tape was used for length-based weight estimation, and actual weight was recorded by a weighing scale. In the first stage, we recruited 769 children. With univariate linear regression, we adjusted the Broselow tape by an 8 % correction factor to enhance accuracy and created a new tape with new weight and height ranges. In the second stage, we recruited 416 children and tested the new ranges for accuracy.
Results:
The Broselow tape overestimates weights with a mean percentage difference of 5-15 % depending on the color zone. Accuracy of the Broselow tape by color-coded zone was between 33-86.6 %, with higher weight color zones showing lower accuracy. The new Indian pediatric weight estimation tool (IPWET), based on the Broselow tape has a weight range of 4-36 kg and height range of 50-150 cm (Broselow tape, 3-36 kg, 46-146.5 cm) and an improved accuracy between 51-97.8 %.
Conclusions:
A remodeled Broselow tape can predict weights with higher accuracy in the Indian pediatric population.
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