This study aimed to prospectively compare the actual weights of urban and rural Nepali children with the estimated weights using the Broselow tape (2017 edition) and the updated APLS formula. showed that the Broselow tape (2007 B edition) had only moderate accuracy for weight estimation. A study done in urban Nepal by Shrestha et al. So, the recent modifications made given of obesity prevalence in western society do not address the issues of developing countries, which may lead to substantial overestimation of the weight of the children and potentially dangerous drug dosing and equipment selection. The undernutrition is still a major concern among pediatrics population in Nepal. The scenario is quite different in low-income countries like Nepal. The studies done in various parts of the world have shown that the Broselow tape accurately measured the weight of children while some studies showed it to be inaccurate. In a simulated pediatric emergency, color coding significantly reduced the deviation from recommended doses. The pre-calculated dosing in the Broselow tape facilitates rapid weight estimation, saves time by providing corresponding drug dosing, and alleviates stress during pediatric resuscitation. In a critical life-threatening condition, it is not judicious to consume the valuable time needed to evaluate, initiate, and monitor patient treatment to calculate the estimated weight, the equipment sizes, and the drug doses.
It is recognized in most medical textbooks and publications as a standard for the emergency treatment of children and is recommended by the Advanced Trauma Life Support and Pediatric Advanced Life Support. The Broselow tape also provides medical instructions including the medication dosages, the size of the equipment, and the level of shock voltage when using a defibrillator. The Broselow pediatric emergency tape is a color-coded length-based tape measure that was developed using height/weight correlations for children who have a maximum weight of roughly 36 kg from a nationally representative sample of children in the USA. Length-based weight estimation is developed as a different alternative to estimate the weight. Wrong estimation of weight or incorrect calculation of drug dosage or equipment size could result in grave consequences. When the accurate weight of the child cannot be obtained, it is usually calculated using an age-based formula such as advanced pediatric life support (APLS) formula which can be incorrect and time-consuming.
It is not always feasible to measure the weight of a child using the standard weighing machine in the ED where the condition is critical and immediate action is required. Incorrect estimation of patient weight, leading to incorrect drug dosing, is one of the most frequently reported errors. The medical error related to the calculation of pediatric medication dosage is very high.
In contrast to adults, the pediatric emergency drug dose, equipment sizes, and defibrillation energy doses are calculated based on the weight of the individual child and are a challenge for the treating emergency physician. The accurate measurement or estimation of the weight of a child is crucial for the effective and optimal acute management of pediatric emergencies. Children with a wide variety of urgent medical and surgical conditions visit the emergency department (ED), which requires immediate life-saving intervention and resuscitation.
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