Broselow Tape in a Pediatric Code. Eliminating

errors

By Dr. Joseph Lewis, M.D.,

JCAHO identified several root causes related to prenatal

death:• Poor communication (72%)• Organizational culture as a barrier to

effective communication and teamwork (i.e., hierarchy and intimidation, failure to function as a team, and failure to follow the chain of communication) (55%)

• Staff competency (47%)• Training processes (40%)

Pediatric Code Issues 

• Drug dosage errors are a major problem.• All medications given to children in a code are

based on the weight of the child in kilograms.• Medication errors occur frequently in the setting

of a pediatric code due to errors in establishing the current weight of the child, converting that weight to kilograms, then establishing the right dose based on the drug formulation. This complexity + stress = errors.

• Pediatric resuscitation drugs are not used often enough to recall the correct dosage, and valuable time is taken to look up the correct dosage by weight. Calculations required may include conversion of weight from pounds to kilograms, as well as dose by weight and concentration of the drug.

The Developers of the Color Coding Kids Hospital System• Doctors Jim Broselow and Bob

Luten have worked in pediatric care for many years. In their ongoing quest to make healthcare as safe as possible for children, they have developed the Color Coding Kids Hospital System which is proven to reduce medical errors in emergency situations.

The Broselow Color Code Systems for Pediatric Codes

• The Broselow system uses a measuring tape which quickly categorizes a child into a certain weight range based on the child’s length. This weight range is indicated on the tape both as a weight and a color. This requires no calculations from the provider and eliminates a major source of medication dosage error.

The Broselow Color Code Systems for Pediatric Codes

• As you can see in the next slide, you place the RED arrow end on one end of the child and the opposite end of the tape indicates the child’s color categorization and approximate weight in kilograms.

The Broselow Color Code Systems for Pediatric Codes

• As you can see in the next slide, a child who measures out to the blue section weighs about 19-23 kilograms and the correct drug dosages of the common cardiac arrest medications are listed in easy to use fashion.

The Broselow Color Code Systems for Pediatric Codes

• Additionally, as you can see in the next slide, the Broselow tape also indicates what size medical equipment is appropriate for the child’s weight, as medical equipment size is also determined by the child’s size.

The Broselow Color Code Systems for Pediatric Codes

• At this point it is easy to understand how the Broselow tape saves time and eliminates errors in medication dosage and equipment size in the stressful environment of the pediatric code.

• Additionally some Broselow tapes even have certain critical medical condition drug groupings like the next slide.

The Broselow Color Code Systems for Pediatric Codes

• To further simplify care and eliminate errors, pediatric code carts are usually color coded by drawer, which contain the appropriate sized equipment for that color. Then when you measure a blue child, everything in the blue drawer should be the appropriate sized equipment for your patient.