This study assessed the accuracy of the Broselow-Luten pediatric emergency tape for weight estimation of 15,000 South Indian children. The mean percentage difference between Broselow weights and actual weights were -2.4%, -17.9%, and -6.3% for children over 10kg, under 18kg, and between 10-18kg respectively. The standard deviation between Broselow zones and actual weights were also high for some groups. The study concluded that the Broselow tape overestimates weights in Indian children by more than 10% for those under 10kg and 30% for those over 18kg, increasing risks of medical errors. An Indian-specific pediatric emergency tape is needed based on the Bro

1. A PROSPECTIVE, CROSS - SECTIONAL
STUDY OF 15,000 SOUTH INDIAN CHILDREN
ASSESSING COMPETENCY OF THE
BROSELOW-LUTEN PEDIATRIC
RESUSCITATION TAPE
Dr. Srihari Cattamanchi,*
Postgraduate Resident, MD (A&EM),
Department of Accident & Emergency Medicine,
Sri Ramachandra Medical University,
Porur – 600 116. Chennai. T.N, India

2. BACKGROUND
No standardized methods available for rapid
weight estimation in children admitted for acute
pediatric emergencies in Chennai, India.
The Broselow tape has shown to improve accuracy
in weight prediction and eliminate the need for
memorization and calculation in Emergency
situations.

3. AIMS & OBJECTIVES
To determines the accuracy of the Broselow
pediatric emergency tape in the Indian pediatric
population.
To find out the standard deviation of Weight from
Broselow pediatric emergency tape to Indian
population.
To determine the usefulness of Broselow pediatric
emergency tape in Indian Settings.

4. METHODS
Design: A prospective, cross-sectional study
Population: 15,000 South Indian children in three
weight-based groups of >10 kg, 10-18 kg and <18 kg.
Duration: 2 months, September 15th 2008 to November
15th 2008.
Setting: The data was collected from children attending
Sri Ramachandra Pediatric OPD and ED in tertiary
care hospitals in Chennai, and also from 16 different
schools in and around Chittoor municipality, in South
India.

5. METHODS
Proforma: Age, sex, height, actual weight, &
Broselow weight were recorded in a preformatted
Performa.
Instrument: Broselow Luten Pediatric Emergency
Tape.
Analysis: Measured weight was compared to
Broselow predicted weight and percent difference
was calculated. A cross – validated correction
factor was derived by non linear regression.
Analysis done using SPSS Ver. 15.0.

6. BROSELOW-LUTEN ZONES
Zone CM Length Kg Weight Age months
0 Grey < 59.5 3 – 5 < 2
1 Pink 59.5-66.5 6-7 2-5
2 Red 66.5-74 8-9 5-11
3 Purple 74-84.5 10-11 11-19
4 Yellow 84.5-97.5 12-14 19-30
5 White 97.5-110 15-18 30-39.5
6 Blue 110-120.75 19-23 39.5-62.5
7 Orange 120.75-133.4 24-29 62.5-83
8 Green 133.4-146.5 30-36 83-107.5

8. PINK
RED
PURPLE
YELLOW
BLUE
ORANGE
GREEN
WHITE
The Broselow-Luten System
Color Wall Chart- Height

9. METHODOLOGY
Inclusion criteria: Children above 2
months of age and below 12 years of age
were be eligible to participate in this
study.
Exclusion: Severely Malnourished
children & child with chronic illness.

10. RESULTS

11. AGE & SEX DISTRIBUTION
0
200
400
600
800
1000
1200
1400
1600
1800
0 1 2 3 4 5 6 7 8 9 10 11 12
NoofChildren
Age in Years
Male
Female

12. DISTRIBUTION ACCORDING TO HEIGHT

13. Distribution According To
Weight.

14. Comparison of Broselow’s & Actual Weight
n = 15,000

15. Results..
• The mean percentage differences were – 2.4
+6.3, and -17.9% for each weight-based group.
• The Broselow color-coded zone Std. dev was
16.12, 11 & 24.5 in their respective group.

16. USEFULLNESS OF
BROSELOW’S TAPE
Pediatric drugs
Defibrillator settings
Infusion Pumps
Ventilator Settings
C.Spine Collar Size

17. Medications
PALS
Rapid Sequence Intubation
Anaphylaxis
Pain and Sedation
Fluids and burns
Seizures & electrolyte correction
Oral Antibiotics

18. BROSELOW-LUTEN ZONES
Zone CM Length Wt in Kg Age in months
0 Grey < 59.5 3 – 5 < 2
1 Pink 59.5-66.5 6-7 2-5
2 Red 66.5-74 8-9 5-11
3 Purple 74-84.5 10-11 11-19
4 Yellow 84.5-97.5 12-14 19-30
5 White 97.5-110 15-18 30-39.5
6 Blue 110-120.75 19-23 39.5-62.5
7 Orange 120.75-133.4 24-29 62.5-83
8 Green 133.4-146.5 30-36 83-107.5

19. Colour Coded Wrist Bands

20. Broselow / Luten Reference
Book

25. TIDAL VOLUME 60-100mL 75 - 125mL100-150mL125-200mL150-250mL200-300mL250-400mL350-500mL
FREQUENCY(BPM) 20 - 25 20 - 25 15 - 25 15 - 25 15 - 25 12 - 20 12 - 20 12 - 20
Parameters: FiO2 100%, PEEP 3 cm H2O, Inspiratory Time >0.6 sec, PIP 2030 cm
H2O, Tidal Volume 10-15 mL/kg—Start low and increase to PIP 20-20 cm H2O
BOLUS ( mL) 130 170 210 260 325 420 530 660
FLUIDS
MAINTENANCE (mL/hr) 28 35 40 45 55 65 70 75
ZONE PINK RED PURPLE YELLOW WHITE BLUE ORANGE GREEN
ZONE PINK RED PURPLE YELLOW WHITE BLUE ORANGE GREEN
MINIMUM HOURLY
URINE OUTPUT (mL/hr)
7-14 9--18 10-20 13-25 16-32 20-40 25-50 35-65
VENTILATOR

26. •Guidelines for Hospitals and Help Reduce CT
Radiation for Children
•Using Color Coding for Kids
•CHICAGO--(BW HealthWire)--Nov. 26, 2001
•GE Medical Systems has applied the Broselow-
Luten Pediatric System.
Colour Coding to reduce Radiation

27. LIMITATIONS
Children below 10 kg were less
included than other Weight Groups.

28. Conclusion
• A total of 15,000 subjects were included.
• Females accounted for 46%.
• Mean age was 7.589 years.
• Height ranged from 55 – 146 cms with a mean
of 119.83 cms.
• Weights ranged from 2.25 - 36.0 kg with a mean
of 21.36 kg.

29. CONCLUSIONS
The Broselow tape overestimates weight by more
than 10% in Indian children <10 kg & 30% in >18 Kgs
increasing risk of medical errors due to incorrect
dosing or equipment selection.
Need for modified Indian pediatric emergency tape
based on Broselow Luten colour coding is the need
of the hour.

30. BENEFITS
Helps in Rapid Weight estimation in ED.
Reducing dosage errors due to wrong weight
estimation.
Colour Coding of our New Pediatric Emergency Dept.
Colour coded band while transferring patient out of ED
into wards.
Gave me inspiration to design a new Indianised
Pediatric Emergency Tape based on this study, which
is under progress.

31. Reference
HOW RELIABLE IS LENGTH-BASED
EMERGENCY WEIGHT ESTIMATION IN INDIAN
CHILDREN? RECONSIDERING THE
BROSELOW TAPE.
NARESH RAMARAJAN, STANFORD
UNIVERSITY,
ANNALS OF EMERGENCY MEDICINE. 2008,
APRIL.

32. Special Thanks
School Management & 13,000
Children of 16 Schools in Chittoor,
Chennai & Bangalore.
Isabell Children Hospital - Chennai,
Govt. Hospital - Chittoor & SRMC -
Chennai.

33. COLOUR - “A Universal Language”
THANK YOU