Broselow Pediatric Emergency Tape

The Broselow Pediatric Emergency Tape, also called the Broselow Tape, is a color-coded tape measure that is used throughout the world for pediatric emergencies. The Broselow Tape relates a child’s height as measured by the tape to his/her weight to provide medical instructions including medication dosages, the size of the equipment that should be used, and the level of shock voltage when using a defibrillator. Particular to children is the need to calculate all these therapies for each child individually. In an emergency the time required to do this detracts from valuable time needed to evaluate, initiate, and monitor patient treatment. The Broselow Tape is designed for children up to approximately 12 years of age who have a maximum weight of roughly 36 kg (80 pounds). The Broselow Tape is recognized in most medical textbooks and publications as a standard for the emergency treatment of children.

Emergency physicians James Broselow and Robert Luten struggled with solving these issues related to the emergency treatment of children in the early 1980s. The result was the invention by Dr. Broselow of a home-made prototype version of the tape in 1985. Dr. Broselow joined with Dr. Luten, an academic physician from the University of Florida and member of the newly formed Pediatric Advanced Life Support (PALS) subcommittee, to do the foundational studies upon which the tape was based and to develop and update the tape over the years.

The tape provides pre-calculated medication doses effectively eliminating the potential errors associated with pediatric emergent dosing preparation and administration. This benefit has had major implications in recent years given the prevalence and magnitude of medication errors. Medical errors are a greater threat to children than adults because their organs are smaller and still developing. An estimated 35% of pediatric patients are incorrectly dosed by EMS providers. Tenfold mathematical errors due to incorrect calculations are a much greater threat to children than adults. Due to the high level of incorrect calculation errors, alternative pediatric emergency tapes that can be customized have gained popularity. A tenfold adult overdose of a standard adult medication would require multiple syringes and tends, therefore, to be obvious to a caregiver, effectively warning of the error. In contrast, for a small child both a 1x correct dose and a 10x overdose of a drug can be administered in the same syringe thus providing no clue as to a potential error. Furthermore, pediatric emergency care is especially prone to error due to the chaotic nature and stress associated with the emergency setting.

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