Officially called the Broselow Pediatric Emergency Tape, a Broselow Tape is a piece of laminated paper designed to aid Emergency Medical Technicians, paramedics, nurses, and other medical personnel with proper medication dosage and equipment sizing for pediatric emergencies. The tape uses a color-coding system, called the Broselow-Luten Color Coding System (B-LPS) to differentiate between various classes of equipment and medications, with each color corresponding to an approximate weight class. In this manner, emergency personnel can quickly identify what is needed to save a pediatric patient's life.

The tape itself was created by Dr. Jim Broselow, an emergency physician who realized that during pediatric emergencies, he and other medical personnel became very panicked and had a general lack of confidence in the care being provided for the young patients. As a result, he decided to begin standardizing the procedures for dealing with pediatric emergencies. Using data from the National Center for Health Statistics, he created a measuring tape designed to approximately correlate height and weight. He later enlisted the help of Dr. Bob Luten, a pediatric emergency doctor, and together they developed the current Broselow Tape.

The tape itself is actually a long strip of laminated paper that folds out to a length of 146.5cm. The tape is divided into different colored regions, which correspond to a patient's height. The colors are then subdivided into two to four different kilogram weights. Each weight lists the appropriate concentration and dosage for emergency medications, and the colors correspond to various sizes of medical hardware (such as nonrebreather masks or endotracheal tubes). The tape itself is designed for children twelve years old or younger, and has a maximum weight of 36 kg. Typically, the tape goes along with a set of pediatric equipment and medications organized by their Broselow-Luten color (typically, colored drawers are used on pediatric crash carts, while colored pouches are used in ambulances). In addition, certain medications come with specially-designed syringes that use Broselow-Luten colors in place of numbered volume markings, eliminating the need for the clinician to perform mathematical calculations. Other drugs list pediatric dosages by color on the package. Additional information, including resuscitation or PAI/RSI drug algorithms, can be found in separate booklets, again separated based on the Broselow-Luten colors.

Recently, there has been some question as to the effectiveness of the Broselow Tape, especially considering the fact that children in America are heavier than their equally-tall counterparts 10 years ago. In fact, Carolyn Nieman, a flight nurse with Metro Flight and instructor at Case Western University's Bolton School of Nursing presented a report in 2003 entitled "Use of the Broselow Tape May Under Resuscitate Children." The study, performed along with seven other researchers, looked at actual children and compared their estimated weight from the Broselow Tape with their actual weight (a study that had never been performed to date). The study itself used 1150 children in Cleveland schools and information in MetroHealth's database of heights and weights for children under 11 who received checkups. The researchers concluded that less than 50% of today's children will receive accurate dosages from the Broselow Tape. The study itself is still awaiting publication, but many emergency services and hospitals still use Broselow Tapes, mainly due to the fact that they are still relatively accurate, and an updated system has yet to be designed.

Broselow Tapes can be ordered from some medical supply stores or medical bookstores (most won't have them in stock, so you'll need to have them backordered), but they are surprisingly expensive. Individual tapes can cost anywhere between $35 and $60 US, and prices are even higher overseas. The best available deal seems to be purchasing a five-pack ($120 US), but this is impractical for just one person. The "official" supplier of Broselow/Hinkle products (which couple the Broselow Tape with color-coded medical supplies) is Armstrong Medical, and this is probably the best available option for American customers. SP Services in the UK also sells Broselow Tapes, though the prices are higher than in the US.

For those interested in learning more about the Broselow Tape and its usage, Duke University has put out a very useful study guide, located at http://dukehealth1.org/deps/clinical_ed.asp.

Sources:
http://dukehealth1.org/deps/clinical_ed.asp
http://flightnurse.case.edu/templates/broselow.htm
http://www.ferne.org/Lectures/icep0404/broselow_icep0404.htm

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