title: Ontario children have outgrown the Broselow tape.
abstract: OBJECTIVE
  The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a well-established length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort.
  
  
  METHODS
  Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated.
  
  
  RESULTS
  A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r  =  0.95577, p < 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% ± 16.9% SD, 95% CI -26.0-40.2). The BT had an ≥ 10% PE 43.7% of the time.
  
  
  CONCLUSIONS
  Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy.
authors.affiliation: Division of Emergency Medicine, University of Western Ontario, London, Canada.
authors.forename: William Ken
authors.initials: WK
authors.lastname: Milne
authors.forename: Abeer
authors.initials: A
authors.lastname: Yasin
authors.forename: Janine
authors.initials: J
authors.lastname: Knight
authors.forename: Daniel
authors.initials: D
authors.lastname: Noel
authors.forename: Richard
authors.initials: R
authors.lastname: Lubell
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
mesh_terms: D000886:Anthropometry / Q000295:instrumentation*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D048788:Growth and Development; D006801:Humans; D007223:Infant; D008297:Male; D009864:Ontario; D010808:Physical Examination / Q000295:instrumentation* / Q000639:trends*; D011446:Prospective Studies; D012424:Rural Population; D018709:Statistics, Nonparametric; D014505:Urban Population