Utility of Body Habitus Parameters to Determine and Improve the Accuracy of the Broselow Tape

Abstract

Objectives:The aims of this study were to determine and improve accuracy of the Broselow Tape (BT) in estimating children's weight by adding body habitus parameters.Methods: This cross-sectional study was conducted in an urban hospital pediatric clinic. Children up to 8 years old coming in for well-child visit were included. Children with acute illness or presence of any chronic condition potentially resulting in growth disturbance and out of BT height range were excluded. The following body habitus parameters were measured using the Centers for Disease Control and Prevention guidelines: actual weight, predicted weight using BT (BTW), mid-thigh circumference (MTC), body mass index, mid-arm circumference, and waist-to-hip ratio.Results: A total of 301 children were enrolled. Of these, 151 were male (50%). Hispanics constituted 160 (53.2%). There was a positive linear association between BTW and actual weight in the overall cohort (adjusted R 2 = 0.9164, P < 0.001). However, there was a difference in this association among children younger than 2 years and children older than 2 years (adjusted R 2 = 0.89 vs 0.4841). Incorporating MTC and/or waist circumference along with BTW in the model increased the accuracy, providing a better estimate of actual weight (adjusted R 2 = 0.94, P < 0.001). Conclusions:We conclude that there might be inaccuracies in the weight predicted by BT in our patient population, especially those weighing more than 15 kg and older than 2 years. Our study also demonstrates that MTC correlates closely with the actual weight and could be used in addition to BT for more accurate weight estimation.

Addition of Midthigh Circumference Improves Predictive Ability of Broselow Tape Weight Estimation

“…The patient sample was also more heterogenous with an oversampling of minority children. In this study, with respect to ethnicity, African American constituted the majority of sample, which is similar to what has been found in the previous institute 13,17 . Like the previous study, this study found that, with increasing age and weight, the BT accuracy decreased in predicting actual weight.…”

“…Our study further validates and expands the findings of Saeed et al 17 by collecting data in an environment that better approximates the types of patients seen in emergent and prehospital settings. The patient sample was also more heterogenous with an oversampling of minority children.…”

“…In a recent study, different body habitus parameters were studied to improve the accuracy of BT in a sample of children treated in a well-child pediatric ambulatory clinic in an urban hospital ambulatory setting 17 . In the study, it was concluded that BT inaccurately predicted weight in children weighing >15 kg and older than 2 years.…”

Weighty Matters: A Real-World Comparison of the Handtevy and Broselow Methods of Prehospital Weight Estimation

“…On average, the Broselow tape under-estimated patient weight by 6.9% and review of the literature demonstrates similar trends, although Both, et al examined data of over 3,000 patients and found that Broselow tended to over-estimate patient weight more frequently than under-estimate patient weight. 7,10,11 Use of the Handtevy method was also associated with under-estimation of patient weight, on average approximately 6.3%. This is consistent with work by Lowe, et al who found that the Handtevy method tended to under-estimate patient weight.…”

“…The Broselow method was developed in the 1980s and has been modified and studied fairly extensively in the intervening years, with varying results. 4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The Handtevy system, initially developed in 2010 as a length and age-based system, has been adapted and can now be used as an exclusively age-based tool for weight estimation. 21 There are few studies evaluating the Handtevy system, most of which were published prior to the development of the solely age-based application, however Rappaport, et al recently published a manuscript reporting almost 90% dosing accuracy using the Handtevy Field Guide (accuracy was based on correct use of the field guide/patient age, not patient weight).…”