Pediatric Community

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!

We actually don't use Broselow carts/tape anymore in our Peds ER because height and weight don't correlate as much as it used to, due to childhood obesity rates. Do you use Epic by any chance? For our emergency code sheets, we use PediCalc which is linked through Epic. You can input the weight and all the code meds as well as defib/cardioversion joules and estimated ETT size pops up. I know that doesn't help much with what/how to store, but might give you an idea of size for weight ranges. I agree with Cam's suggestion of utilizing the EMSC National Pediatric Readiness checklist.

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!

Greetings all - After playing peds transport nurse for 25 or so years, the question about Broselow (& later Handtevy) continues to revolve around "the obese kids" - Few quick insights & thoughts to consider from research & when I've spoken to both physicians over the years about this specific topic - interestingly, and utterly informally, they both have the same reply, "get over it" - in the upcoming sometime in 2025 Broselow tape, the color zone/age/length weights listed (no weight change from the previous 2019/2020 version) were compared against the most current CDC data: Ideal Body Weights Reference, National Health Statistics Reports, Number 160, August 4, 2021, CDC.gov - and they actually still worked really well for ideal body weigh when paired with age - the key is to remember that both systems keep coming back to the idea of "ideal body weight" - i.e. if you go to Anytime Fitness, this is what you "should weigh"... not necessarily what you do weigh - 

the original studies on the broselow-luten system were done in the mid-80's to see if length correlated with equipment size, i.e. endo tubes, etc - & they did - then other systems, apps, etc over the years continued to evolve to reflect, equipment, meds, etc 

for emergency equipment - length/age (this is how tall a "normal" x,y,z kid should be" works really well for equipment - "skinny or fat", your airway should be about the same size, i.e for ETT's, etc

but for meds... this is where the the common queries come in - going back to the ideal body weight reference - the vast majority of "it's a real emergency" meds given to kids, are dosed on "ideal body weight" - most drips when the kid is going to the peds ICU are dosed on ideal body weight - parkland/brooke burn fluids are dosed on ideal body weight - pain meds are based on ideal body weight - it keeps coming back to ideal body weight... but, of course there are exceptions, however, in my research, the two that keep coming up that are indeed based on "actual body weight" are succinylcholine, aka. sux, & amiodarone, aka. amio - with the introduction of rocuronium "roc" & suggamadex (reversal for roc), sux continues to be used far less & less in children - but it's still out there & if you want a kid adequately paralyzed for intubation & are using sux, it should be based on the actual weight - same idea in the happily really rare event (outside of the peds ICU) in which you have a kid in VT/VF and need to give amiodarone - amio is based on actual weight - so if you want a child to stop having funky arrhythmias with the help of amiodarone - dose it based on actual body weight - but for just about everything else in an emergency... ideal body weight is where it's at

that's my humble thoughts 

hope this helps

cheers

Scott

We actually don't use Broselow carts/tape anymore in our Peds ER because height and weight don't correlate as much as it used to, due to childhood obesity rates. Do you use Epic by any chance? For our emergency code sheets, we use PediCalc which is linked through Epic. You can input the weight and all the code meds as well as defib/cardioversion joules and estimated ETT size pops up. I know that doesn't help much with what/how to store, but might give you an idea of size for weight ranges. I agree with Cam's suggestion of utilizing the EMSC National Pediatric Readiness checklist.

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!

Greetings all

a few from the list e-mailed me privately today in response to the post about broselow / handtevy ages/weights/etc

below is a chart that i compiled today that details current broselow tape ages/weights as well as handtevy ages/weights

as you will see - the two systems are nearly identical until the older kids, i.e. 10-11+ years old when you are "bigger than broselow" but handtevy app reflects older children as well

hope this helps as always

cheers

scott

Greetings all - After playing peds transport nurse for 25 or so years, the question about Broselow (& later Handtevy) continues to revolve around "the obese kids" - Few quick insights & thoughts to consider from research & when I've spoken to both physicians over the years about this specific topic - interestingly, and utterly informally, they both have the same reply, "get over it" - in the upcoming sometime in 2025 Broselow tape, the color zone/age/length weights listed (no weight change from the previous 2019/2020 version) were compared against the most current CDC data: Ideal Body Weights Reference, National Health Statistics Reports, Number 160, August 4, 2021, CDC.gov - and they actually still worked really well for ideal body weigh when paired with age - the key is to remember that both systems keep coming back to the idea of "ideal body weight" - i.e. if you go to Anytime Fitness, this is what you "should weigh"... not necessarily what you do weigh - 

the original studies on the broselow-luten system were done in the mid-80's to see if length correlated with equipment size, i.e. endo tubes, etc - & they did - then other systems, apps, etc over the years continued to evolve to reflect, equipment, meds, etc 

for emergency equipment - length/age (this is how tall a "normal" x,y,z kid should be" works really well for equipment - "skinny or fat", your airway should be about the same size, i.e for ETT's, etc

but for meds... this is where the the common queries come in - going back to the ideal body weight reference - the vast majority of "it's a real emergency" meds given to kids, are dosed on "ideal body weight" - most drips when the kid is going to the peds ICU are dosed on ideal body weight - parkland/brooke burn fluids are dosed on ideal body weight - pain meds are based on ideal body weight - it keeps coming back to ideal body weight... but, of course there are exceptions, however, in my research, the two that keep coming up that are indeed based on "actual body weight" are succinylcholine, aka. sux, & amiodarone, aka. amio - with the introduction of rocuronium "roc" & suggamadex (reversal for roc), sux continues to be used far less & less in children - but it's still out there & if you want a kid adequately paralyzed for intubation & are using sux, it should be based on the actual weight - same idea in the happily really rare event (outside of the peds ICU) in which you have a kid in VT/VF and need to give amiodarone - amio is based on actual weight - so if you want a child to stop having funky arrhythmias with the help of amiodarone - dose it based on actual body weight - but for just about everything else in an emergency... ideal body weight is where it's at

that's my humble thoughts 

hope this helps

cheers

Scott

We actually don't use Broselow carts/tape anymore in our Peds ER because height and weight don't correlate as much as it used to, due to childhood obesity rates. Do you use Epic by any chance? For our emergency code sheets, we use PediCalc which is linked through Epic. You can input the weight and all the code meds as well as defib/cardioversion joules and estimated ETT size pops up. I know that doesn't help much with what/how to store, but might give you an idea of size for weight ranges. I agree with Cam's suggestion of utilizing the EMSC National Pediatric Readiness checklist.

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!

Greetings all - After playing peds transport nurse for 25 or so years, the question about Broselow (& later Handtevy) continues to revolve around "the obese kids" - Few quick insights & thoughts to consider from research & when I've spoken to both physicians over the years about this specific topic - interestingly, and utterly informally, they both have the same reply, "get over it" - in the upcoming sometime in 2025 Broselow tape, the color zone/age/length weights listed (no weight change from the previous 2019/2020 version) were compared against the most current CDC data: Ideal Body Weights Reference, National Health Statistics Reports, Number 160, August 4, 2021, CDC.gov - and they actually still worked really well for ideal body weigh when paired with age - the key is to remember that both systems keep coming back to the idea of "ideal body weight" - i.e. if you go to Anytime Fitness, this is what you "should weigh"... not necessarily what you do weigh - 

the original studies on the broselow-luten system were done in the mid-80's to see if length correlated with equipment size, i.e. endo tubes, etc - & they did - then other systems, apps, etc over the years continued to evolve to reflect, equipment, meds, etc 

for emergency equipment - length/age (this is how tall a "normal" x,y,z kid should be" works really well for equipment - "skinny or fat", your airway should be about the same size, i.e for ETT's, etc

but for meds... this is where the the common queries come in - going back to the ideal body weight reference - the vast majority of "it's a real emergency" meds given to kids, are dosed on "ideal body weight" - most drips when the kid is going to the peds ICU are dosed on ideal body weight - parkland/brooke burn fluids are dosed on ideal body weight - pain meds are based on ideal body weight - it keeps coming back to ideal body weight... but, of course there are exceptions, however, in my research, the two that keep coming up that are indeed based on "actual body weight" are succinylcholine, aka. sux, & amiodarone, aka. amio - with the introduction of rocuronium "roc" & suggamadex (reversal for roc), sux continues to be used far less & less in children - but it's still out there & if you want a kid adequately paralyzed for intubation & are using sux, it should be based on the actual weight - same idea in the happily really rare event (outside of the peds ICU) in which you have a kid in VT/VF and need to give amiodarone - amio is based on actual weight - so if you want a child to stop having funky arrhythmias with the help of amiodarone - dose it based on actual body weight - but for just about everything else in an emergency... ideal body weight is where it's at

that's my humble thoughts 

hope this helps

cheers

Scott

We actually don't use Broselow carts/tape anymore in our Peds ER because height and weight don't correlate as much as it used to, due to childhood obesity rates. Do you use Epic by any chance? For our emergency code sheets, we use PediCalc which is linked through Epic. You can input the weight and all the code meds as well as defib/cardioversion joules and estimated ETT size pops up. I know that doesn't help much with what/how to store, but might give you an idea of size for weight ranges. I agree with Cam's suggestion of utilizing the EMSC National Pediatric Readiness checklist.

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!

This is such fantastic information - thank you, Scott!!

Greetings all - After playing peds transport nurse for 25 or so years, the question about Broselow (& later Handtevy) continues to revolve around "the obese kids" - Few quick insights & thoughts to consider from research & when I've spoken to both physicians over the years about this specific topic - interestingly, and utterly informally, they both have the same reply, "get over it" - in the upcoming sometime in 2025 Broselow tape, the color zone/age/length weights listed (no weight change from the previous 2019/2020 version) were compared against the most current CDC data: Ideal Body Weights Reference, National Health Statistics Reports, Number 160, August 4, 2021, CDC.gov - and they actually still worked really well for ideal body weigh when paired with age - the key is to remember that both systems keep coming back to the idea of "ideal body weight" - i.e. if you go to Anytime Fitness, this is what you "should weigh"... not necessarily what you do weigh - 

the original studies on the broselow-luten system were done in the mid-80's to see if length correlated with equipment size, i.e. endo tubes, etc - & they did - then other systems, apps, etc over the years continued to evolve to reflect, equipment, meds, etc 

for emergency equipment - length/age (this is how tall a "normal" x,y,z kid should be" works really well for equipment - "skinny or fat", your airway should be about the same size, i.e for ETT's, etc

but for meds... this is where the the common queries come in - going back to the ideal body weight reference - the vast majority of "it's a real emergency" meds given to kids, are dosed on "ideal body weight" - most drips when the kid is going to the peds ICU are dosed on ideal body weight - parkland/brooke burn fluids are dosed on ideal body weight - pain meds are based on ideal body weight - it keeps coming back to ideal body weight... but, of course there are exceptions, however, in my research, the two that keep coming up that are indeed based on "actual body weight" are succinylcholine, aka. sux, & amiodarone, aka. amio - with the introduction of rocuronium "roc" & suggamadex (reversal for roc), sux continues to be used far less & less in children - but it's still out there & if you want a kid adequately paralyzed for intubation & are using sux, it should be based on the actual weight - same idea in the happily really rare event (outside of the peds ICU) in which you have a kid in VT/VF and need to give amiodarone - amio is based on actual weight - so if you want a child to stop having funky arrhythmias with the help of amiodarone - dose it based on actual body weight - but for just about everything else in an emergency... ideal body weight is where it's at

that's my humble thoughts 

hope this helps

cheers

Scott

We actually don't use Broselow carts/tape anymore in our Peds ER because height and weight don't correlate as much as it used to, due to childhood obesity rates. Do you use Epic by any chance? For our emergency code sheets, we use PediCalc which is linked through Epic. You can input the weight and all the code meds as well as defib/cardioversion joules and estimated ETT size pops up. I know that doesn't help much with what/how to store, but might give you an idea of size for weight ranges. I agree with Cam's suggestion of utilizing the EMSC National Pediatric Readiness checklist.

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!

Hello! I recently took over as one of our department's PECC nurses. One of my jobs is to revitalize the equipment and how we store it. Does anyone have any evidence based references for what is kept in your peds broselow carts? Particularly sizing for equipment I am hoping to cross reference it and see how we can improve! Many thanks!