Although the Broselow tape has been validated in both ambulatory 9, 10, 11, 12 and simulated emergency situations 13 in the United States and is believed to reduce complications arising from inaccurate drug dosing and equipment sizing, but given the prevalence of malnutrition and consequent aberration in growth in Indian children it may overestimate the weight of these children. The Broselow tape recommends dosages of emergency drugs and preferred equipment sizes, on the basis of predicted weight, which, in turn, is estimated on the basis of actual height (height-weight correlation). The Indian Academy of Pediatrics supported Paediatric Advanced Life Support Programme recommends that Broselow tape is used in such circumstances 8. It can also be predicted using age-based formulae such as advanced paediatric life support (APLS) formula or updated APLS formula 5, 6, 7. In such situations, various methods are used to determine the drug dosages and sizes of equipment: ‘guesstimates’ based on the child's apparent size or stature 1, predicting it on the basis of length 2, foot length 3, age 4 or a combination of above 4. In addition, when children present with shock or respiratory arrest or circulatory collapse, it may be necessary to carry out endotracheal intubation straight away. There is hardly any time to determine weight or height and calculate dosages of emergency drugs. When children present in a critical state, the caregivers are expected to provide instant care and administer drugs immediately. In contrast to adults, drugs are administered to infants and children on the basis of actual weight or surface area.
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