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The Broselow and Handtevy Resuscitation Tapes: A Comparison of the Performance of Pediatric Weight Prediction
Calvin G Lowe1, Rashida T Campwala1, Nurit Ziv1
11Division of Emergency and Transport Medicine,Children's Hospital Los Angeles,Los Angeles,CaliforniaUSA.
Insights
The Broselow tape generally provides more accurate pediatric weight estimations than the Handtevy tape. This study compared Broselow and Handtevy tapes using US children's data, finding Broselow superior overall for predicting actual weight.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Medical Device Performance Evaluation
Background:
- Accurate weight estimation is crucial for pediatric emergency medicine, particularly for medication dosing and equipment selection.
- Length-based resuscitation tapes, such as the Broselow and Handtevy tapes, are commonly used to estimate pediatric weights when direct measurement is not feasible.
- Variations in pediatric body composition can affect the accuracy of these estimation tools.
Purpose of the Study:
- To compare the performance of the Broselow and Handtevy pediatric length-based tapes in predicting the actual weights of children in the United States.
- To evaluate the bias, precision, and accuracy of weight predictions made by each tape across different length ranges.
Main Methods:
- A descriptive study utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2009-2010.
- Weights and lengths of children aged newborn to 13 years were extracted.
- Children's data were categorized into Broselow and Handtevy zones based on measured lengths, and mean weights were compared to predicted weights.
Main Results:
- The Broselow tape demonstrated better overall performance in bias, precision, and accuracy compared to the Handtevy tape across most length ranges.
- Both tapes tended to underestimate children's weights.
- The Broselow tape was more accurate for shorter children, while the Handtevy tape showed higher accuracy for taller children.
- Excluding children with a body mass index (BMI) ≥95th percentile improved the Handtevy tape's performance, but the Broselow tape remained superior.
Conclusions:
- The Broselow tape is a more effective tool for pediatric weight estimation compared to the Handtevy tape.
- The Broselow tape more closely approximates the actual weights of US children across various lengths.
- Findings support the continued use and potential refinement of length-based estimation tools in pediatric emergency care.
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. Lowe CG , Campwala RT , Ziv N , Wang VJ . The Broselow and Handtevy resuscitation tapes: a comparison of the performance of pediatric weight prediction. Prehosp Disaster Med. 2016;31(4):364-375.
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