The Broselow Tape gets an electronic make-over

By Molly Merrill
03:11 PM
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The Broselow Pediatric Emergency Tape, a well-known paper-based medical chart used by pediatric emergency personnel to provide specific medical instructions to doctors based on a child’s measurements, is undergoing an electronic revamp that displays the information via a large-screen digital format.

The revamp is part of a collaborative effort between Virginia Tech's College of Engineering, Roanoke-based Carilion Clinic Children's Hospital, and Hickory, N.C.-based physician James Broselow, who created the original method some 25 years ago.

The Broselow Tape is a long, durable tape measure used on a child during a medical emergency. It is designed for children 12-years-old or younger, and having a maximum weight of roughly 80 pounds. Using a color coded-format, it provides specific medical instructions – amounts of medicines to dispense or level of shock voltage to emit from a defibrillator, for instance – to medical caregivers based on the height and then subsequent weight of the child.

The revamped tape will include displaying this information on a large LCD monitor within emergency rooms, for all personnel to see. Additional displayed information will include medicines administered to the patient, including the time of administration and the next scheduled allotment. In the instance of burns, an automated calculation of the affected surface area will be displayed, along with automated calculation of fluid resuscitation.

"We are converting the existing Broselow Tape into an electronic format to improve resuscitation team communications and patient safety," said Andre A. Muelenaer Jr., an associate professor of pediatrics at the Virginia Tech Carilion School of Medicine, adjunct professor at Virginia Tech-Wake Forrest University School of Biomedical Engineering and Science, and director of the Pediatric Medical Device Institute, located in Roanoke, Va.

A click of a mouse/remote control can move responders from one screen to another. The software running the newly-dubbed eBroselow software program runs on LabVIEW, owned by National Instruments. Known as TEAM Broselow, the method is being tested at various hospitals, including facilities in Roanoke, Va., Austin, Texas, and Winston-Salem, N.C., and will be fine tuned as additional input comes in from doctors, nurses and other medical personnel, said Muelenaer.

Many of the new features already include input from medical personnel around the country, Muelenaer said. One example: the ability to track by barcode-scan the exact types and amounts of medicine administered to the patient. "The idea is to give multiple people access to the same info, on a big screen," said Al Wicks, an associate professor of mechanical engineering at Virginia Tech, who serves on the Pediatric Medical Device Institute's leadership team with Muelenaer.

Much of the work to digitize the Broselow Tape for display on LCD televisions was completed by Carlos Guevara, a Virginia Tech master's student in mechanical engineering. Emergency medical personnel still will rely on the physical laminated tape to determine the child's care-need level, before utilizing the digital display version.

"Doing this was a rather simple task," said Guevara. "The challenges arose in an attempt to take advantage of current technology in order to develop a much more enhanced device, such as using the available drug concentration information to calculate volume to administer once a drug has been scanned."

The idea for a digital version of the Broselow Tape was developed by Broselow, who was working with a collaborator on a Web-based adaptation as far back as three years ago, and Stacy Steans, a pediatric physician at Roanoke's Carilion Clinic Children's Hospital, who was thinking about converting the paper-based data to a wireless format displayed on a monitor. Eventually, Steans and Muelenaer at Carilion, the Virginia Tech College of Engineering and Broselow all came together to work on the process.

"We showed them what we had developed and they showed us what they had developed," said Broselow, who developed the tape after moving from a private practice set-up to emergency room, and seeing the need for large medical teams to have set standards for child emergency care response. "The initial content on the large screen was a combination of what their thinking was and the content information we had."

Funding for the project came from the Childress Institute for Pediatric Trauma. Rural hospitals, such as those located throughout Southwest Virginia, could benefit most from the software device, more so than urban hospitals with high-capita populations of children. "There are not as many children, so there are not as many cases," he said.

Broselow and his company are continuing work on several digital formats for emergency rooms of all types and additional user formats such as iPhone applications and several publications, plus additional emergency response needs such as wounds sustained from chemical weapons.