Growth Spurt
Registered nurse Carolyn Nieman recently discovered that
sometimes motherhood is the mother of invention. Ms. Nieman, an
ACNP/flight nurse specialist for Metro Life Flight and faculty at
Case's Bolton School of Nursing presented her project “Use of the
Broselow Tape May Under Resuscitate Children,” for which she
shared credit with seven other researchers at the 2003 Research
ShowCASE. Three years ago, while watching her thirteen-year-old
daughter and ten-year-old son perform at a school concert, she first
thought of the idea that she displayed at the showcase. Soon afterward,
she began devising a way to improve on the “Broselow Tape”
method traditionally used in emergency medical situations involving
children requiring resuscitation. The method is used to estimate
medication dosing and equipment sizing based on a child’s age and
body size.
“I always thought my kids were normal size, but
that night they seemed so much smaller than everyone else on
stage,” she says. “So when I came to work, I started
thinking there’s no way that the Broselow Tape can be accurate
anymore, and it became more clear to me everywhere I went that kids
seemed bigger and bigger.” She enlisted the help of several other
flight nurses she worked with to research the current accuracy of the
Broselow Tape, which had never been validated in a pediatric
population, according to Ms. Nieman. The team worked to correlate the
device against a large sample of children.
Their research analyzed measurements of about 1,150
children ages 5 to 11 from several Greater Cleveland schools, as well
as the database numbers for the MetroHealth System’s measurements
of children from birth to age 11 taken during annual well-child visits.
The team collected enough height and weight data to conclude that less
than fifty percent of pediatric patients today would receive an
accurate dosage estimate based on the Broselow system, especially
children who are older or heavier. Ms. Nieman’s research group is
in the process of completing its research paper and getting it
published, which they hope to do this summer. “We want to get the
word out to people in emergency medical systems, fire departments,
emergency rooms, and so on, so they can determine what they want to do
with the information,” she says.
Nieman CT, Manacci CF, Super DM, Mancuso C & Fallon WF.
(2006). Use of the Broselow tape may result in underresuscitation of
children. Academic Emergency Medicine, 13, 1011-1019.
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