Pune: A new colour-coded measuring tape designed specifically using Indian children’s growth data can help doctors quickly and fairly accurately estimate a critically ill child’s weight in an emergency.
A multicentre study led by researchers at Jehangir Hospital here and published in the journal ‘Indian Paediatrics’ tested 2,253 critically ill children in paediatric intensive care units (PICUs) at 13 hospitals across the country using “Indianized Pediatric ALS (Advanced Life Support) tape”, with encouraging results, though the study’s authors said real-world impact will have to be further studied.
In emergencies, doctors often cannot weigh a child on a scale — the child may be unconscious, on life support, or too unstable to move. Yet nearly every medication dose, fluid volume and piece of resuscitation equipment used on a child is calculated based on body weight. So they use Broselow tape, a colour-coded, length-based tape used globally to estimate the child’s weight range, based on which medication doses and equipment sizes are calculated.
“The problem is that the Broselow tape was built using American children’s growth data, and multiple Indian studies have shown it tends to overestimate the weight of Indian children,” Dr Vaman Khadilkar, senior paediatric endocrinologist at Jehangir Hospital here, said.
An overestimated weight can mean a child is unintentionally given a higher dose of medication than needed, said Dr Anuradha Khadilkar, deputy director of Hirabai Cowasji Jehangir Medical Research Institute at Jehangir Hospital.
The problem was recognised earlier in India, but it was difficult to compensate for this difference in emergencies. “What was lacking was a simple, ready-to-use tape developed from contemporary Indian growth data,” Dr Khadilkar said.
“The Indianised tape keeps the same colour sequence and general design as the Broselow tape, so hospital staff don’t need to be retrained. It just recalibrates the length ranges for each colour band for Indian children’s growth data,” Dr Sagar Lad, paediatric intensivist at Jehangir, said. The tape has drug and equipment recommendations aligned to IAP-PALS protocols.
The researchers — including Dr Sonali Wagle-Patki, a scientist at Hirabai Cowasji Jehangir Medical Research Institute — measured children under 12 years old admitted to PICUs between April and December 2025, comparing the tape’s colour-band estimate against the child’s actual measured weight. The tape correctly identified the right weight range (colour band) in 79.9% of children. Overall, 78.6% of weight estimates were within 10% of the child’s actual weight, rising to 84.6% when the margin was widened to 15%. The tape’s overall bias was small — on average it underestimated weight by just 0.6 kg (0.08%) across the full sample.That said, accuracy varied by weight group: the tape slightly underestimated weight in smaller children (13.1% in the lowest bands) and slightly overestimated it in bigger children (10.3% in the highest bands). Agreement between different hospital staff members reading the same colour band was also rated “strong”.
In comparison, Broselow tape’s margin of error is 11% for children under five years and 3.3% among older children.
The researchers said the tool performed better than another Indian alternative, InChiTape, with the caveat that the study used a different growth reference and more subjects under five years. This could affect a direct comparison.
While the tape offers Indian PICUs a homegrown solution, the study’s authors called for a direct comparison with Broselow tape and further research into other region-specific variants.
Participating institutes included Kalinga Institute of Medical Sciences (Bhubaneswar), Indraprastha Apollo Hospital (New Delhi), KMCH Institute of Health Sciences and Research (Coimbatore), Rainbow Children’s Hospital (Bengaluru and Hyderabad), Gandhi Medical College (Bhopal), Jehangir and two other Pune centres — Shaishav Children’s Hospital and Sahyadri Superspeciality Hospital.
