New product eliminates need for guesstimates’

Color-coded tape correlates precalculated dosages, infusion rates, and equipment sizes with a child’s length

When seconds count, guessing a child’s weight or trying to recall complicated dosage formulas can cause every ED nurse’s nightmare—medication errors. The Broselow Pediatric Resuscitation Tape is a color-coded system that eliminates the need for complicated calculations or "guesstimates." The child’s length is measured with a color-coded tape, with precalculated resuscitation drugs and infusion rates listed along with correct equipment sizes for the patient.

The length-based tape is very accurate and easy to use, says Linda Manley, RN, BSN, CEN, CCRN, EMS Coordinator and flight nurse for MED Flight at Children’s Hospital in Columbus, OH. "With children who are immobilized due to a potential neck injury, or one who requires oxygen or assisted ventilation, you simply cannot get a weight in the ED," she notes. "Thus, this method is very helpful and should be used more often. It works best for children who are 3 kg ( a newborn) to about 25 kg (about the size of an 8 year old)."

The color-coded tape also alleviates anxiety over computing dosages during pediatric cardiac arrests, seizures, and traumas. "The anxiety associated with memorization and calculation under duress can sabotage the whole resuscitation," says James Broselow, MD, FACEP, the emergency physician who developed the system. "Not only can decimal points be easily misplaced making ten-fold errors in dosing, but simple mistakes such as not warming a child or not recognizing shock can be precipitated by the associated performance anxiety."

A universal color-coding system is currently being developed to use the same color codes for dosages for emergency, inpatient, and home care. "A child could have his length measured on a rainbow tape and then the dosage be administered in a rainbow cup or syringe by simply matching the appropriate color," Broselow explains.

Length, not weight, is a more accurate measure to go by when calculating dosages, says Broselow. "A system developed around color-coded weight zones would result in the overdosage of obese children," he notes. "A child’s actual weight does not correlate as well with pediatric equipment selection as does his length.

In most instances, the new system will give dosages in actual ccs of medication. "If a dose has been calculated in a different manner, the system will function as a fail-safe mechanism allowing instant verification that the dose is a "normal" dose for that child prior to administration," notes Broselow.

Color-coded OTC sheets will simplify aftercare instructions, and injury and accident prevention guidelines will be incorporated using the same concept. The universal color-coding system is expected to be available later this year.

[Editor’s note: American Health Consultants has published a pocket-sized reference card containing pediatric drugs and dosages. For more information see page 64.]