A Descriptive Analysis of the Reliability of the Broselow Tape for Use in the US Pediatric Trauma Population A Trauma Quality Improvement Program Study

Objectives: Length-based weight estimation tools are used for estimating a pediatric patient’s weight when the actual body weight is not readily available. We sought to evaluate the proportion of children that were > 20% outside of the estimated weight range using data from the Trauma Quality Improvement Program (TQIP) registry. Methods: We completed a retrospective review using data from the TQIP registry from 2017 to 2022. We included patients below 15 years of age who had a documented height within the range of the Broselow tape. We excluded patients without documentation of both height and weight and those that were > 2× over the upper weight limit. We define underestimated as a patient’s estimated weight being lower than their measured weight and overestimated as their estimated weight being higher than the measured weight. We particularly focused on under or overestimation by > 20% as our primary outcome. Results: A total of 204,097 patients met our inclusion criteria. Two percent of patient’s weights were overestimated by > 20%. Fourteen percent of patient’s weights were underestimated by > 20%. Conclusions: We found that nearly 1 in 7 patients’ measured body weight was above the weight range estimated by the Broselow tape by > 20%, creating the potential for medication underdosing.