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A Descriptive Analysis of the Reliability of the Broselow Tape for Use in the US Pediatric Trauma Population: A
Ian S McCullough1, Melissa L Givens1, Kelli J Welter2
1Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD.
Insights
Pediatric weight estimation tools like the Broselow tape may underestimate children's actual weight. Fourteen percent of patients were underestimated by over 20%, risking medication errors.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Pharmacology
- Trauma Care
Background:
- Length-based weight estimation tools are crucial for pediatric patients when actual weight is unavailable.
- Accurate weight estimation is vital for appropriate medication dosing in children.
Purpose of the Study:
- To evaluate the accuracy of length-based weight estimation tools in pediatric trauma patients.
- To determine the proportion of children whose actual weight falls outside the estimated range by more than 20%.
Main Methods:
- Retrospective review of the Trauma Quality Improvement Program (TQIP) registry (2017-2022).
- Inclusion of pediatric patients (<15 years) with documented height within Broselow tape range.
- Exclusion of patients lacking height/weight data or exceeding the tape's upper limit by >2x.
Main Results:
- Analysis included 204,097 pediatric patients.
- 2% of weights were overestimated by >20%.
- 14% of weights were underestimated by >20%.
Conclusions:
- Nearly 1 in 7 pediatric patients had weights underestimated by >20% using length-based tools.
- This underestimation poses a significant risk for medication underdosing in pediatric trauma care.
Objectives:
Length-based weight estimation tools are used for estimating a pediatric patient's weight when the actual body weight is not readily available. We sought to evaluate the proportion of children that were >20% outside of the estimated weight range using data from the Trauma Quality Improvement Program (TQIP) registry.
Methods:
We completed a retrospective review using data from the TQIP registry from 2017 to 2022. We included patients below 15 years of age who had a documented height within the range of the Broselow tape. We excluded patients without documentation of both height and weight and those that were >2× over the upper weight limit. We define underestimated as a patient's estimated weight being lower than their measured weight and overestimated as their estimated weight being higher than the measured weight. We particularly focused on under or overestimation by >20% as our primary outcome.
Results:
A total of 204,097 patients met our inclusion criteria. Two percent of patient's weights were overestimated by >20%. Fourteen percent of patient's weights were underestimated by >20%.
Conclusions:
We found that nearly 1 in 7 patients' measured body weight was above the weight range estimated by the Broselow tape by >20%, creating the potential for medication underdosing.
