Pediatric Dosing Tools Under Review: What the 2025 Broselow Recall Means for EMS Operations

Most EMS providers are familiar with the Broselow Tape and its role in pediatric emergencies.

However, the 2025 Class I recall of certain Broselow Pediatric Emergency Rainbow Tapes, along with ongoing updates to pediatric dosing standards, raises an important operational question:

Are the tools currently in use fully aligned with current guidance and free from known risk?

This is not about introducing new information. It is about verification, consistency, and ensuring that the tools relied on in critical moments are both accurate and current.

Context: Updates and Recall

Concerns about the accuracy of length-based pediatric dosing tools have been discussed in emergency medicine for years, particularly as patient populations have changed.

In 2025, a new edition of the Broselow Tape was released with updated clinical content. Shortly after, a recall was issued.

In May 2025, AirLife initiated a recall of certain Broselow Pediatric Emergency Rainbow Tapes, which the U.S. Food and Drug Administration classified as a Class I recall. This classification indicates a reasonable probability that use of the device could result in serious adverse health consequences.

An expanded field removal and additional guidance were issued in December 2025.

Affected Products and Scope

The recall applied to:

• Broselow Pediatric Emergency Rainbow Tape (2025 Edition)

• Broselow ALS Organizers

• Versions identified as AirLife brand, 2025 Edition (Rev 2 and Rev 3 Print Versions)

Agencies were instructed to remove affected products from service, quarantine or discard them, and ensure all personnel were informed.

Nature of the Risk

The recall was driven by incorrect clinical information printed directly on the device.

This included errors in defibrillation energy settings, sodium bicarbonate concentrations, and multiple medication dosing references.

Additional identified issues included:

• Vecuronium listed as a concentration rather than a weight-based dose

• Flumazenil dosing reflecting a tenfold overdose in a reference section

• Ketamine dosing for analgesia listed at ten times the appropriate level

In a time-sensitive pediatric emergency, even small inconsistencies can introduce hesitation, delay, or incorrect dosing. The risk is not only the error itself, but the disruption it creates in high-pressure decision-making.

Why This Matters Operationally

Most agencies are aware of the Broselow system and likely aware of the recall at a high level. Where variability can occur is in implementation.

Across services, it is not uncommon to see:

• Multiple versions of tapes still in circulation

• Equipment carts assembled at different times with different references

• Inconsistent alignment between printed tools and digital resources

• Limited redundancy for verifying dosing in the field

The recall highlights a broader reality: even widely trusted tools require active validation within an operational system.

Quick Verification Points for Agencies

For EMS leaders and teams, this is an opportunity to confirm alignment across the system:

• Verify which Broselow versions are currently in circulation

• Confirm removal of any affected 2025 editions

• Check that medication dosing references are consistent across carts and kits

• Ensure all personnel are aware of recall guidance

• Evaluate whether a secondary method of dosing verification is available in the field

This type of review supports consistency and reduces the risk of variation during critical calls.

The Shift Toward Verification

Emergency medicine continues to move toward layered safety, where no single tool is relied on in isolation.

This includes:

• Updated physical references

• Alternative pediatric dosing systems

• Digital tools that allow for real-time calculation and cross-checking

The goal is not to replace trusted tools, but to ensure they are supported by systems that allow for verification when it matters most.

How Three Peaks Supports Field Operations

At Three Peaks Medical Supply, the focus is on supporting EMS providers with both reliable equipment and tools that strengthen decision-making in the field.

The Three Peaks platform includes a medication dose calculator built on pediatric Broselow principles, designed to support real-time use.

This allows providers to:

• Calculate weight-based medication doses quickly

• Cross-check dosing independently of printed materials

• Reduce reliance on a single reference point

• Maintain confidence in high-pressure scenarios

Moving Forward

The 2025 Broselow recall does not change the role these tools have played in pediatric care.

It does reinforce the importance of system-level awareness, consistency, and verification.

Ensuring that tools are current, aligned, and supported by reliable processes is part of maintaining readiness across any EMS organization.

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About Three Peaks Medical Supply

Three Peaks Medical Supply is focused on supporting EMS, Fire, and emergency response teams with practical, field-ready solutions that improve readiness and operational consistency.

In addition to supplying high-quality medical kits and equipment, Three Peaks is a technology platform designed to address real-world challenges in the field. This includes tools such as a pediatric medication dose calculator based on Broselow principles, helping providers quickly verify weight-based dosing during critical situations.

The goal is to complement existing systems, reduce variability, and support confident decision-making when it matters most.

Three Peaks works alongside agencies to provide scalable solutions that align equipment, training, and technology, helping teams stay prepared, consistent, and ready to respond.