Pediatric Advanced Life Support Tape for Indian Children
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Vaman Khadilkar1, Sagar Lad2, Shruti Mondkar2
1Pediatric Endocrinology Unit, Hirabai Cowasji Jehangir Medical Research Institute, Pune, India. Correspondence to: Dr. Vaman Khadilkar, Pediatric Endocrinology Unit, Jehangir Hospital, Pune, and Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India. vamankhadilkar@gmail.com.
Insights
A new advanced life support (ALS) tape, tailored for Indian children using local data, offers more accurate weight estimation than the Broselow tape. This improved accuracy can help reduce errors in pediatric emergency care.
Area of Science:
- Pediatric Emergency Medicine
- Biomedical Engineering
- Growth Monitoring
Background:
- Accurate weight estimation is critical for pediatric emergency care, influencing medication dosages and equipment selection.
- Existing weight estimation tools, like the Broselow tape, may have limitations in diverse populations.
- A need exists for a weight estimation tape specifically adapted to the anthropometric data of Indian children.
Purpose of the Study:
- To develop and validate a novel advanced life support (ALS) tape using Indian multicenter height/length and weight data.
- To ensure accurate weight estimation from recumbent length for pediatric patients in India.
- To compare the accuracy of the new ALS tape against the established Broselow tape.
Main Methods:
- Designed a new ALS tape by aligning median weights with median heights/lengths from recent Indian growth data.
- Maintained the color-coding system consistent with the Broselow tape for ease of transition.
- Validated the weight estimation accuracy of the new tape against the Broselow tape in a tertiary care hospital setting.
Main Results:
- The new Indianized ALS tape demonstrated higher median height correlations for each color band compared to the Broselow tape.
- A significant proportion of children, across various color bands, were assigned a higher Broselow color band, indicating potential weight overestimation by the Broselow tape.
- The new ALS tape exhibited minimal percentage differences in estimated weight versus actual weight (-0.5% for under-5 years, 0.2% for older children).
Conclusions:
- The developed Indianized ALS tape provides more accurate weight estimations for Indian children.
- Implementation of this new ALS tape has the potential to decrease errors in calculating emergency medications, fluid volumes, and equipment sizes.
- Further validation studies are recommended for the new ALS tape within Indian pediatric emergency departments.
Objective:
To design a specific advanced life support (ALS) tape based on recent Indian multicenter height/length and weight data to accurately estimate the weight from the recumbent length.
Methods:
We designed the new ALS tape by matching the median weights to median heights/lengths from the recently published Indian multicenter growth data, maintaining the same color codes as the Broselow tape. The accuracy of weight estimation for the newly designed ALS tape was validated and compared with the Broselow estimated weights at a tertiary care hospital.
Results:
The color (weight) band matched median heights (cm) from the new ALS tape were higher (53.0 vs 53.9 for grey, 63.1 vs 67.4 for pink, 70.6 vs 76.4 for red, 79 vs 85.5 for purple, 89.6 vs 95.5 for yellow, 101.9 vs 107.5 for white, 126.1 vs 130.5 for orange and 137 vs 140.5 for green) than the Broselow tape. For every color band on the newly designed ALS tape, a sizable proportion of children (27% for grey, 78% for pink, 83% for red, 38% for purple, 63% for yellow, 41% for white, 35% for blue, 54% for orange) recorded a higher Broselow color band, suggesting overestimated weights at each color band. The percentage difference in the estimated weight from the actual weight was very small (-0.5% for under-5 years and 0.2% for older children) using the new ALS tape as compared to Broselow tape.
Conclusion:
This Indianized ALS tape estimated Indian children's weights more accurately. Use of the newly designed ALS tape may reduce the errors in calculating emergency medications, fluids and equipment sizes. Further studies are required to validate this tape in pediatric emergency departments in India.
