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Discussion

Pediatric Code Carts in ED and pt weight

Hi,

For those in the ED who do not use the Broselow cart system, what method do you use to calculate pediatric weight for code meds? Do you use the 2X age + 4 method? Or 3X age +7? Do you use the Broselow tape for measurement of weight only, eventhough you do not use the Broselow cart system? We have been cited by the state for having a Broselow tape on the ED cart (we explained it was for weight determination only), because that is not the standard in the rest of the hospital. Thanks for any input.

Featured Replies

We use the broslow tape. Why did you get cited for having it?

I'm a little confused- were you cited because you had the tape but not the cart itself??

Every hosp I've worked at uses the Broslow tape...

  • Moderator
Every hosp I've worked at uses the Broslow tape...

Yep ... although I've now heard them called the "length-based resuscitation tape" the last time I went through the ACLS/PALS stuff. LBRT ... good grief, do we need more acronyms? What, was Dr. Broselow getting royalities each time we said it? LOL

I don't think I've been in a hospital that didn't have the tape and the bags. All the ambulances I've worked on use the tape/bag system also. It's just easy to use,lay the tape on the bed and grab the bag. I can understand using it just for a reference, but isn't that only using half the system?

  • Author

We were cited for having the Broselow tape in the ED, because we do not have it on the peds carts in rest of the pediatric areas of hospital, and they are looking for "standardization" among all of the peds code carts. Our ED only uses the tape for weight estimation... we don't use the other calculations on the tape. The state just didn't like us to have the tape on one cart, and not the others. We don't need it on the others, because we know the weight of the child in the inpatient areas. We are looking to other ED's to see which weight estimation system they use, if they don't use the Broselow tape (or if they only use the tape for weight estimation). Thanks!

  • Experts

Hmmm - may I ask what state you are in? In IL - the standard is to use the Broselow tape for the ER and actually weigh the peds pts in the inpt areas.

All three Children's hospitals I have worked have used the Braslow cart in the ED and a Pedi cart in the rest of the house- as you said- we already know the weight.

Braslow is the standard of care, I believe. Now, I could see them not liking that you use the tape without the actual Braslow cart that it was meant for.

As for standardization, that really does not make any sense to me either- you cannot compare ED to the rest of the house.

That being said, I work at a children's hospital trauma center and all of our traumas go directly to us in the PICU and bypass the ED completely. We almost never know the weight with these kids and usually EMS has already "estimated" a weight when they hand off the kid. Technically, we use the 2X(age+4) to estimate and dose from there.

  • Experts

We use the Broselow tape for weight and do not use the cart/bag system.

The way our policy is written makes me suspect we may have been dinged in the past - the policy states it is only used to estimate weight in situations where obtaining an accurate weight is not prudent.

If someone made a 'generic' tape that didn't incorporate the Broselow 'system' we'd be happily using it instead.

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