Internationalizing the Broselow tape: how reliable is weight estimation in Indian children

Acad Emerg Med. 2008 May;15(5):431-6. doi: 10.1111/j.1553-2712.2008.00081.x.

Abstract

Objectives: The Broselow pediatric emergency weight estimation tape is an accurate method of estimating children's weights based on height-weight correlations and determining standardized medication dosages and equipment sizes using color-coded zones. The study objective was to determine the accuracy of the Broselow tape in the Indian pediatric population.

Methods: The authors conducted a 6-week prospective cross-sectional study of 548 children at a government pediatric hospital in Chennai, India, in three weight-based groups: < 10 kg (n = 175), 10-18 kg (n = 197), and > 18 kg (n = 176). Measured weight was compared to Broselow-predicted weight, and the percentage difference was calculated. Accuracy was defined as agreement on Broselow color-coded zones, as well as agreement within 10% between the measured and Broselow-predicted weights. A cross-validated correction factor was also derived.

Results: The mean percentage differences were -2.4, -11.3, and -12.9% for each weight-based group. The Broselow color-coded zone agreement was 70.8% in children weighing less than 10 kg, but only 56.3% in the 10- to 18-kg group and 37.5% in the > 18-kg group. Agreement within 10% was 52.6% for the < 10-kg group, but only 44.7% for the 10- to 18-kg group and 33.5% for the > 18-kg group. Application of a 10% weight-correction factor improved the percentages to 77.1% for the 10- to 18-kg group and 63.0% for the >18-kg group.

Conclusions: The Broselow tape overestimates weight by more than 10% in Indian children > 10 kg. Weight overestimation increases the risk of medical errors due to incorrect dosing or equipment selection. Applying a 10% weight-correction factor may be advisable.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Anthropometry / instrumentation*
  • Body Weight*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Equipment Design
  • Female
  • Hospitals, Pediatric
  • Humans
  • India
  • Infant
  • Male
  • Medication Errors / prevention & control
  • Reference Values
  • Reproducibility of Results