The PAWPER tape, the Wozniak method and the Mercy method achieved an acceptable level of accuracy in studies from low- and middle-income countries and should preferentially be used and further advanced for clinical emergency medicine practice. The Broselow tape (PW10 47.1%) achieved a moderate accuracy and age-based estimates a very low accuracy (PW10 11.8–47.5%). The PAWPER tape, parental estimates, the Wozniak method and the Mercy method were the most accurate systems with percentage of weight estimates within 10% of actual weight (PW10) accuracies of 86.9%, 80.4%, 72.1% and 71.4% respectively. The 2D systems and parental estimates performed best overall. This meta-analysis evaluated the accuracy of weight estimation systems in children from studies from low- and middle-income countries.Īrticles from low- and middle-income countries were screened for inclusion to evaluate and compare the accuracy of existing systems and the newer dual length- and habitus-based methods, using standard meta-analysis techniques. Many weight estimation methodologies in current use have been shown to be inaccurate, especially in low- and middle-income countries with a high prevalence of underweight children. When weight cannot be measured during the management of medical emergencies in children, a convenient, quick and accurate method of weight estimation is required, as many drug doses and other interventions are based on body weight. CONCLUSION: The evidence suggests that when compared with other methods of estimating medication dosing and airway equipment size, the Broselow tape is the most reliable predictor in most situations, especially in younger pediatric patients. In addition, it appears to be more accurate for use with younger patients. RESULTS: Although the Broselow tape may underestimate the weight of outlier pediatric patients, it is still the most accurate tool available. The initial search showed 84 publications, 24 with relevance to this review. Literature related to or appearing to have a commercial interest was not included in this review. Inclusion criteria included (a) peer-reviewed literature and (b) original research articles. METHODS: A systematic review was conducted using three primary search engines, including PubMed, Ebscohost, and ProQuest. We present an analysis of literature and research of the Broselow tape as a means of estimating weight in pediatric patients to address medication dosing. The Broselow tape provides clinical providers with a method of quickly estimating medications and airway adjuncts for pediatric patients. OBJECTIVE: Pediatric emergency medicine departments can be overwhelmed with conflicting literature on the accuracy of the Broselow tape.

Ultimately, the Broselow tape is only a guide that should be considered, whereas the final determination of drug dosage and equipment sizes will be determined by the patient situation and the clinical provider's experience and training. The evidence suggests that when compared with other methods of estimating medication dosing and airway equipment size, it is the most reliable predictor in most situations, especially in younger pediatric patients. Using multiple search engines, this review of the literature examined the potential of the Broselow tape to be an effective guide for emergency medicine teams. However, since the development of the Broselow tape, there has remained a controversy over the accuracy of the tape for estimating weight to determine pediatric resuscitation needs.