Weight Estimation Method in Emergency Department in Malaysia: Is Broselow Tape (Bt) Reliable?

Abstract

Broselow tape is a well-established medical equipment to estimate body weight with pre-calculated drug dosages and emergency equipment sizes. The aim of this study is to determine whether weight estimation based on Broselow Tape corresponds to the actual weight of pediatric population in Klang Valley, Malaysia. The aim of this study is to determine the accuracy of BT usage in pediatric population attending the emergency department. A total of 1163 children attended emergency department at green zone were approached to be the sampling frame. BT weight estimation colour code was determined based on the colour which the child’s heel fell on the tape. Scatter plot was done to determine the range of actual weight scattered around the range of BT. Bland-Altman plot was used to identify the bias relation between the BT and actual weight measurement. In our population, the BT was an ineffective method to predict weight of pediatric patients with body length of <0.6m and >0.9m. Incorrect estimation of children weight leads toward poor clinical judgment. Therefore, clear indication of the BT limitations should be addressed before using the method as part of emergency department standard operating procedure for management of pediatric patients.

A systematic review and meta-analysis of the accuracy of weight estimation systems used in paediatric emergency care in developing countries

“…A very large multinational database study. Limitations: BT not actually used Sahar 2016 [60] 1163 Malaysia P 0–12 yrs BT MPE, PELOA None Yes 4 S: U M: U O: L Findings : BT underestimated weight in small children and overestimated weight in older children. It was not accurate.…”

The accuracy of emergency weight estimation systems in children—a systematic review and meta-analysis

“…Limitations: Broselow tape not actually used. Sahar 2016 [ 161 ] 1163 Malaysia P 0 to 12 years Broselow tape None 1, 2 Low Findings: Broselow tape underestimated weight in small children and overestimated weight in older children. It was not accurate.…”

Validation of two pediatric resuscitation tapes

“…1,8 Thus, it is being compared to newer weight estimation methodologies of dual length-and habitus-based methods like the Pediatric Advanced Weight Prediction in the Emergency Room (PAW-PER) tape. 6,9 Data on weight estimation using the Broselow tape were done on the western population, and there have been few studies done in Malaysia, 8 Philippines (Castor F, Cu J, unpublished data, 2017), Singapore, 10 and Thailand. 11 To date, there was no literature published on the validation of PAWPER weight estimation systems among the Southeast Asian population.…”

“…11 To date, there was no literature published on the validation of PAWPER weight estimation systems among the Southeast Asian population. With the conflicting results of the use in extremes of weight and limitation in the study population, [1][2][3][4][5][6][7][8][9][10] it is relevant to further determine the accuracy and precision of these pediatric emergency tapes. This study is the first to use both the Broselow and PAWPER weight estimation methods among Filipino children.…”

“…The Broselow tape is the most commonly used pediatric weight estimation tape. However, recent international studies have shown its lack of sufficient accuracy by underestimating weights among obese children 1,8 . Thus, it is being compared to newer weight estimation methodologies of dual length‐ and habitus‐based methods like the Pediatric Advanced Weight Prediction in the Emergency Room (PAWPER) tape 6,9 .…”