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The accuracy of the Broselow tape as a weight estimation tool and a drug-dosing guide – A systematic review and meta-analysis

      Abstract

      Aims

      The Broselow tape is widely used as a weight-estimation device and drug-dosing guide aid, but concerns about its accuracy and its efficacy have emerged in the last decade. The aim of this study was to systematically review the literature to analyse the accuracy of the Broselow tape as a weight estimation device and review evidence of its utility as a drug-dosing guide.

      Methods

      This was a MOOSE-driven systematic review and meta-analysis, which focused on studies evaluating the accuracy of the Broselow tape and studies reviewing its use as a drug-dosing aid.

      Main results

      The tape has undergone substantial changes over the years, but there was no evidence to show that the changes have improved weight-estimation performance. The weight-estimation accuracy of the tape was suboptimal in all populations, with just over 50% of children receiving an estimation within 10% of their actual weight. The overestimation of weight in low- and middle-income countries was often extreme. This indicated a significant potential for potentially harmful medication errors. The limited available evidence on the value of the tape as a drug-dosing guide indicated that the tape was frequently used incorrectly and contained insufficient information to function without additional resources.

      Conclusions

      The Broselow tape lacked sufficient accuracy as a weight estimation and drug-dosing tool when compared to other available techniques. In addition, the Broselow tape contains insufficient drug-dosing information to function as a complete resuscitation aid without additional material. The frequent rate of incorrect usage of the tape indicated that appropriate training with the tape is mandatory to reduce errors.

      Abbreviations:

      2D (two-dimensional), 3D (three-dimensional), APLS (Advanced Paediatric Life Support formula), ARC (Australian Resuscitation Council formula), BG (Best Guess formula), BMI (body mass index (kg/m2)), BT (Broselow tape), DWEM (devised weight-estimating method), ED (emergency department), EMS (emergency medical services), EPLS (European life support formula), FE (fixed effects), HCP (healthcare provider), IBW (ideal body weight), IQR (interquartile range), IV (inverse variance), MAC (mid-arm circumference), MPE (mean percentage error), MT (mercy tape), NCHS (National Centre for Health Statistics), PAWPER (paediatric advanced weight prediction in the emergency room), PW10 (percentage of estimates within 10% of actual weight (%)), PW20 (percentage of estimates within 20% of actual weight (%)), RE (random effects), TBW (total body weight), TJ (Traub-Johnson formula), TK (Traub-Kichen formula)

      Keywords

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