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Health Brief: Errors common with pediatric weight estimation techniques :

December 29, 2015

Emergency care providers made errors when estimating pediatric patients’ weight regardless of the technique used, according to a prospective study.

Accurate weight measurements are crucial when dosing drugs, replacing fluids and sizing equipment during emergency care. A variety of methods have been devised to estimate patients’ weight when calibrated scales are inaccessible or cannot be used due to severe illness or injury.

The authors of this study compared the accuracy of seven techniques: visual estimation, Advanced Pediatric Life Support (APLS), Luscombe and Owens, Broselow tape, devised weight estimation method, and 2D and 3D Mercy Tape. Raters included 80 pediatric nurses, emergency medical technicians and paramedics, who estimated the weight of volunteer children ages 2 months to 16 years.

A total of 2,800 weight estimates were obtained. None of the methods were 100% accurate.

When accuracy was measured by the percentage of estimates within 10% of body weight, the 2D Mercy Tape was most accurate (53%), while visual estimation and APLS were least accurate (27%). When accuracy was defined as a measurement within 20% of body weight, the 2D Tape was most accurate (78%) and APLS was least accurate (42%).

Results also showed:

  • Weights were underestimated greatly in most children using visual estimation.
  • Although only 63% of cases were eligible for estimation with Broselow tape, raters assigned a weight in 96% of cases.
  • The wrong side of the 2D Tape was used in 24% of cases.
  • Raters made mathematical errors in nearly a quarter of APLS calculations and 9% of Luscombe and Owens calculations.
  • Nearly all overweight children were misclassified using the devised weight estimation method: 19% were categorized as slim and 77% average. In addition, 3% of obese children were classified as slim and 45% as average.

The authors concluded that ongoing training in weight estimation techniques may improve performance.

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