Mike Wells1, Lara Nicole Goldstein2, Alison Bentley3, Sian Basnett4, Iain Monteith5. 1. Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa. Electronic address: mike.wells@emergencymedicine.co.za. 2. Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa. Electronic address: drg666@gmail.com. 3. Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa. Electronic address: Allison.bentley@wits.ac.za. 4. Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa. Electronic address: sibazz26@gmail.com. 5. Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa. Electronic address: montyza@gmail.com.
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.
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.
Authors: Ogochukwu N Iloh; Benedict Edelu; Kenechukwu K Iloh; Obianuju O Igbokwe; Ikenna K Ndu; Obinna C Nduagubam; Uzoamaka C Akubuilo; Ijeoma N Obumneme-Anyim; Joy N Eze; Chidiebere D I Osuorah Journal: Ital J Pediatr Date: 2019-11-19 Impact factor: 2.638