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Doctors, nurses, and parents are equally poor at estimating pediatric weights
M Harris1, J Patterson, J Morse
1Emergency Medicine Residency of the Lehigh Valley, Department of Emergency Medicine, St. Luke's Hospital, Bethlehem, Pennsylvania, USA.
Insights
Pediatric weight estimation by parents, nurses, and physicians in emergency departments is unreliable. All groups underestimated children's weights, with significant discrepancies in estimates impacting patient care.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Assessment
- Patient Safety
Background:
- Accurate weight estimation is crucial for pediatric emergency care, particularly for medication dosing.
- Previous studies have shown variability in weight estimation, but direct comparisons between parents, nurses, and physicians are limited.
Purpose of the Study:
- To compare the accuracy of weight estimations made by parents, nurses, and physicians for children in an emergency department setting.
Main Methods:
- A study involving 100 pediatric patients (0-8 years) in an urban teaching emergency department.
- Parents, triage nurses, and examining physicians independently estimated each child's weight, blinded to other estimates and actual weight.
Main Results:
- All groups (parents, nurses, physicians) tended to underestimate pediatric weights, with no significant difference in underestimation among the groups.
- Estimate ranges were wide across all groups, indicating significant individual variability.
- A substantial percentage of estimates deviated by over 15% from the actual weight: 16% for parents, 40% for nurses, and 29% for physicians.
Conclusions:
- Weight estimations by parents, nurses, and physicians in the emergency department are similarly unreliable.
- The findings highlight a critical need for improved methods for accurate pediatric weight estimation in emergency settings to ensure patient safety.
Objective:
To evaluate the relative accuracy of physicians, nurses, and parents in estimating the weight of children presenting to the emergency department.
Methods:
One hundred pediatric patients between the ages of 0 and 8 years presenting to an urban teaching emergency department (40,000 patients per year) were enrolled over a 1-month period (September 1996). The parents, triage nurse, and examining physician were asked to estimate the patient's weight, each blinded to the others' estimates and the child's actual weight.
Results:
Parents, nurses, and physicians all slightly underestimated patient weights (P < 0 .05), but these groups did not differ among themselves (P > 0 .05). The total range of estimates was broad in each group (parents +292% to -41%, nurses +30% to -36%, and physicians +43% to -56%). There was no significant relationship between estimates with regard to age, weight, or sex. Twenty-nine percent of physicians' estimates, 40% of nurses' estimates, and 16% of parents' estimates differed from the actual weight by more than 15%.
Conclusion:
Emergency department pediatric weight estimates by parents, nurses, and physicians are significantly and similarly unreliable.