The Broselow tape comes to the iPhone, Safe Dose is a solid pediatric drug reference tool

By: Manoj M. Lalu, MD, PhD

Pediatric dosing of therapeutics can be a confusing affair at the best of times — especially for those of us who don’t provide care for children on a regular basis.

Even ten fold medication errors can be easily made when dealing with extremely small volumes of medication (“death by decimal point”).

Moreover, it is not uncommon for the concentration of stock medication to be changed – potentially leading to even more errors. Safe Dose is an app that addresses these problems in an easy to use format. Of note, Dr. James Broselow (of the “Broselow Tape” that is widely used for pediatric trauma and resuscitation) is behind this app.

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The opening screen brings you to a menu where you can select your patient by weight or by Broselow tape color. The selection of weight ranges from 3 kg to only 36 kg.

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Alternatively, medications can be listed alphabetically, by broad categories, or searched by name. The alphabetical listing notably supports both trade and generic names (e.g. Zemuron and Rocuronium).

Recently viewed medications can be recalled quickly from the last link on the front-page menu.

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If you select a weight and then a medication it brings you an information screen. Various available concentrations of a medication are shown in table format along with the weight-adjusted volume to be administered.

Thus, as long as the weight and indication (i.e. sedation vs. induction) selected are correct, no further calculations are needed. Under stressful circumstances this would definitely be a valuable feature!

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Under the dosing table, essential information for drug administration is listed. I particularly liked that only critical information is listed here for each drug.

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A final feature of this app worth expanding on is the “By Category” selection from the opening menu. Within this section you can select from a broad number of problems/indications for medication.

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Choosing one of these indications brings you to a sub-section where various drugs are listed by type. For instance, under Rapid Sequence Induction (“RSI”), pre-treatment, paralytic and induction agents are listed. Obviously, some familiarity with the medications is necessary as no guidance is given on which medications to select (e.g. RSI with the pancuronium or vecuronium options listed would definitely not be ‘rapid’!).

Another oddity I found in the RSI section was that endotracheal tube size was listed in “Post-Intubation Management”. This information should probably be listed in its own category prior to any induction drugs.

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Overall, I found Safe Dose to be a useful app during my last rotation through Pediatric Anesthesia. Undoubtedly, the potential for medication errors would be reduced if practitioners were to rely on the information provided by this app (or similar apps).

One addition that would make the app even more useful would be a “Favorites” category where you could list your frequently used drugs.

In general, though, I think anyone who directly administers drugs to pediatric patients (anesthesiologists, emergency medicine physicians, nurses, paramedics) will find this app potentially useful.

Price:

  • $9.99

Likes:

  • Well laid out app, easy to read and follow
  • No calculations required – final volumes of medications listed
  • Trade and generic names listed

Dislikes:

  • No method to create a list of frequently used drugs
  • Limited weight selection
  • ETT size selection is hidden in post-intubation management category
  • No guidance for drug selection given within the “By Category” section

Conclusion:

  • A useful and well designed calculator app for pediatric therapeutics

iTunes:

Author:

iMedicalApps Team

3 Responses to The Broselow tape comes to the iPhone, Safe Dose is a solid pediatric drug reference tool

  1. Peter Lazar, CEO eBroselow October 25, 2011 at 11:40 am #

    Thanks for this excellent review! We will be working to implement the changes you suggested. Please keep an eye out for the features we plan to release in the near future: expanding dose information through adult weights and implementing a logging feature so that you can record the doses you administer in each case. We will also add bar code scanning to further prevent dosing errors. We have two other apps on iTunes: SafeDoseEMS and Artemis. Additionally, we have a more comprehensive web based system that is used in hospitals. http://www.ebroselow.com

  2. Najmul Salman March 22, 2012 at 5:53 am #

    With the obesity crisis in children especially teenager weighing 200-300 pounds now not an infrequent encounter, should there be a corrrection factor added for these children

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