The process of creating that first Broselow Tape opened my eyes to how a bad system can confound even the most dedicated healthcare professionals. The system – estimating the weight, weight-based dosing, mgs per/kg, micrograms per kg, conversions to mLs, dilutions, equipment sizes, ventilator settings, missing critical equipment, fragile patients and stress – was a formula for disaster. Why was it a bad system? Because there was no system! In response to this problem, I teamed up with Bob Luten, one of the early PEDS EM leaders who was part of the original PALS subcommittee. We started working together to build a system. Our first step was to look at airway and other equipment needs and Bob headed up studies in the OR showing that length was the best determinant of correct ET tube size.
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