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Are methods used to estimate weight in children accurate?
Karen Black1, Peter Barnett, Rory Wolfe
1Department of Emergency Medicine, Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
Accurate child weight estimation is crucial for resuscitation. The devised weight estimation method and Broselow tape are most accurate for estimating pediatric weight in emergencies.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Assessment
- Medical Device Evaluation
Background:
- Accurate estimation of a child's weight is critical during resuscitation, but often unknown.
- Several methods exist to estimate pediatric weight, but their accuracy varies.
Purpose of the Study:
- To evaluate the accuracy and clinical utility of six different pediatric weight estimation methods.
- To compare these methods across various pediatric weight and age ranges.
Main Methods:
- A study involving 495 children in a tertiary pediatric emergency department.
- Inclusion of weight, height/length, and body habitus assessment.
- Evaluation of six weight estimation methods: APLS, Broselow tape, DWEM, Oakley table, Traub-Johnson, and Traub-Kichen.
Main Results:
- The devised weight estimation method (DWEM) and Broselow tape demonstrated the best overall performance.
- The Broselow tape has a length limitation of 145 cm.
- Other methods showed good performance in mid-range weights but were less accurate for extreme weights.
Conclusions:
- The DWEM and Broselow tape are the most accurate methods for estimating pediatric weight.
- These methods are recommended for use in emergency situations when direct weighing is not feasible.
Objective:
The exact weight of a child undergoing resuscitation is usually not known. Several methods to estimate a child's weight have been proposed. We evaluated six of these methods to determine their accuracy and clinical usefulness across a range of weights and ages.
Method:
Children attending a tertiary paediatric emergency department on 30 non-consecutive days were weighed, a length or height was obtained and an estimation of body habitus (slim, average or heavy) made by a single investigator, Karen Black (KB). All children less than 145 cm were also measured using the Broselow tape. Six methods of weight estimation were employed and the calculated weight compared to the true weight. The weight estimation methods evaluated were the advanced paediatric life support (APLS) method, Broselow tape, devised weight estimation method (DWEM), Oakley table, Traub-Johnson and the Traub-Kichen methods.
Results:
Four hundred and ninety-five children were included in the study. Children were evenly distributed among the weight groups of less than 10 kg, 10-25 kg, 25-40 kg and over 40 kg. The methods with the best overall performance were the devised weight estimation method and Broselow tape although the latter has a length limitation of 145 cm. The other methods performed well in the middle two weight groups but poorly outside these groups.
Conclusions:
The most accurate methods of weight estimation in children are the Broselow tape and the devised weight estimation method. We recommend the use of either of these methods in emergency situations where direct weighing is not possible.