Broselow Carts Chelsea Melrose, RN, ADN
Patient Case Study • A two-year old boy is transferred from another hospital for evaluation of aspiration pneumonia. He arrives with no IV access. He is crying but begins having periods of lethargy. The doctors are preparing to intubate and are calling out for different equipment and medications. • What feelings or emotions would you have in this scenario?
Perhaps, these feelings…? • Anxiety • Scared • Nervous • Frantic • Fear • Unease
What’s my point? • Currently, our ECC uses a standardized pediatric resuscitation cart, which is organized by intervention: 1 drawer with intubation equipment, 1 with supplies for IV access, & 1 with resuscitation medications. • Disadvantages to this system: • Multiple drawers have to be opened to obtain necessary equipment • Equipment must be sorted to find appropriately sized equipment for patients ranging in age • Staff who are unfamiliar with the location of items may cause undue delay in finding correct items
What’s my point? • Caring for the injured child requires special knowledge, precise management, and scrupulous attention to detail. A one-decimal point shift can result in a potentially lethal error in dosing. • Infrequent usage and the stress associated with treating children in life or death situations, health care workers often forget detailed information needed in these critical situations. • Is there an easier way????
Broselow Carts • Invented by James Broselow to find a better way to handle the highly stressful situation of pediatric resuscitation. • Drawers are color-coded and contain all the equipment necessary for airway management and intravascular access to resuscitate a patient in the specific length/weight range. • Each drawer contains pre-calculated resuscitation drugs and infusion rates
Advantages to the Broselow System • Ensures correct, appropriate-size equipment • Provides immediate access to critical supplies • Used in tandem with Broselow tape allows for quick determination of weight and drug dosages
Standardized Carts vs Broselow Carts • In 2005, the Official Journal of The American Academy of Pediatrics published a study comparing the two carts. • Performed by medical professionals that specialized in pediatrics • Prospective, randomized cross-over trial • 21 pediatric healthcare professionals were assigned the role of obtaining equipment during 2 simulated codes alternately using either the standardized or color-coded system. • 10% of the 21 subjects had prior experience with the Broselow cart versus 62% with the standard cart.
Results of the Study • Of the 21 subjects: • 62% found the Broselow cart “easy” or “very easy” to use versus 33% for the standard cart • 67% preferred the Broselow care, 10% preferred the standard cart, and 23% had no preference • Which cart provided the equipment quicker? • Intubation supplies and NG tubes were found significantly fast using the Broselow cart (mean time 29.1 and 30 seconds) versus the standard cart (mean time 38.7 and 38.2 seconds) • Correct equipment was provided 99% of the time with the Broselow cart versus 83% of the time with the standard cart.
Let’s again review, Advantages to the Broselow System • Ensures correct, appropriate-size equipment • Provides immediate access to critical supplies • Used in tandem with Broselow tape allows for quick determination of weight and drug dosages • May decrease anxiety in highly critical scenarios • Has been found easier to use than standard carts • Allows health care provider to locate correct equipment faster
The End. • Any Questions??? • Comments??