Pediatrics ·
PAWPER Tape Outperforms Broselow Tape for Pediatric Weight Estimation
A systematic review and meta-analysis included 250 studies, although only nine enrolled children requiring resuscitation. In pooled comparisons, the PAWPER tape was more accurate than the Broselow tape, but no included studies reported patient outcomes.
- Nine included studies enrolled children requiring resuscitation.
- PAWPER outperformed Broselow in paired accuracy comparisons.
- Age-based formulas had P10 below 50%.
- No studies reported patient outcomes.
Researchers systematically reviewed studies identified in Embase, PubMed, and the Cochrane Library through December 19, 2025, assessing tools for estimating children’s weight and calculating medication doses during resuscitation. The review included 250 studies overall; nine enrolled children requiring resuscitation. Outcomes included weight-estimation accuracy, drug-dose accuracy, and time to drug administration.
Across analyses, the PAWPER length-based tape, which adjusts for body habitus, outperformed the Broselow tape on these measures. In a paired meta-comparison, estimates within 10% of actual weight (P10) were more likely with PAWPER (odds ratio 2.48; 95% CI, 2.04–3.02). Age-based formulas were consistently inaccurate, with P10 below 50%. Findings were consistent across countries grouped by income level.
The review found no patient-outcome data, so it does not establish whether greater estimation or dosing accuracy improves clinical outcomes. Many source studies excluded children longer than the tapes’ range and those with skeletal deformities or growth restrictions, limiting applicability to these groups.
In practice
For clinicians estimating weight and medication doses during pediatric resuscitation, this review found that the PAWPER tape, which incorporates body habitus, was more accurate than the Broselow tape across reported measures; age-based formulas were consistently inaccurate. These findings concern estimation and dosing accuracy, not demonstrated patient benefit: no included studies reported clinical outcomes. Applicability is also uncertain for children outside tape length ranges and those with skeletal deformities or growth restrictions, who were often excluded from source studies.
AI-generated clinical interpretation · Not editor-reviewed
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Pediatrics: Weight Estimation and Dose Calculation in Resuscitation: A Systematic Review and Meta-Analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.