1. The Broselow Tape Eliminating Drug Dose ErrorsBy
Dr. Joseph Lewis, M.D.,

2. The Developers of the Color Coding Kids Hospital System
Dr Jim Broselow and Dr. Bob Luten have worked in pediatric care for many years. They have developed the Broselow Tape: Color Coding Kids Hospital System which is proven to reduce medical errors in emergency situations.

3. The Broselow Tape
The Broselow system starts with a special measuring tape which converts the child’s length into an accurate weight in kilograms. The tape uses statistical data which matches height to expected weight within a specified range. This weight range is indicated on the tape both as both a weight range and a color. This requires no calculations from the provider and eliminates a major source of medication dosage error.

4. Why develop a color code system?
Drug dosage errors are a major problem in pediatric codes.
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 and then establishing the right dose based on the drug formulation. The complexity of these calculations and the stress of the situation lead to errors in calculation and thus medication dosage errors.

5. The Un-familiar
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.

6. 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.

8. 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 kilograms and the correct drug dosages of the common cardiac arrest medications are listed in easy to use fashion.

10. 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.

12. 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.

14. 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.

15. 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%)