The Broselow and Handtevy Resuscitation Tapes: A Comparison of the Performance of Pediatric Weight Prediction

Prehosp Disaster Med. 2016 Aug;31(4):364-75. doi: 10.1017/S1049023X16000455. Epub 2016 May 25.

Abstract

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.

Keywords: AHA American Heart Association; BMI body mass index; CDC Centers for Disease Control and Prevention; MD mean difference; MPE mean percentage error; NHANES National Health and Nutrition Examination Survey; body weights and measures; emergency treatment; pediatrics; prehospital care.

MeSH terms

  • Adolescent
  • Body Weight
  • Body Weights and Measures / instrumentation*
  • Body Weights and Measures / methods
  • Child
  • Child, Preschool
  • Dimensional Measurement Accuracy*
  • Drug Dosage Calculations
  • Emergency Treatment / instrumentation
  • Emergency Treatment / methods
  • Emergency Treatment / standards*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nutrition Surveys / statistics & numerical data
  • Observer Variation
  • Pediatrics / instrumentation
  • Pediatrics / methods
  • Pediatrics / standards*