Internationalizing the Broselow tape: how reliable is weight estimation in Indian children.
OBJECTIVE
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.
Ramarajan
Naresh
N
Stanford University School of Medicine, Stanford, CA, USA. nareshr@stanford.edu
Krishnamoorthi
Rajesh
R
Strehlow
Matthew
M
Quinn
James
J
Mahadevan
Swaminatha V
SV
D000293:Adolescent; D000886:Anthropometry / Q000295:instrumentation*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D012016:Reference Values; D015203:Reproducibility of Results