Make your Best Guess: An updated method for paediatric weight estimation in emergencies

Tinning, Katie; Acworth, Jason

doi:10.1111/j.1742-6723.2007.01026.x

Cited by 75 publications

(65 citation statements)

References 10 publications

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“…When body weights were not available, pediatric IM/SC epinephrine dosing was assessed according to the child's age group (<6, 6-12, or >12 years) as suggested in the literature [21]. For IV bolus injections, age was used to estimate the body weight [26] to calculate the dose. In both adults and children, overdosing with IV continuous infusion was not analyzed since continuous infusion is usually titrated to clinical effects and not all of the information necessary to calculate the total dose was available.…”

Section: Methodsmentioning

confidence: 99%

Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the Beijing Pharmacovigilance Database

Wang

Ma²,

Xing

et al. 2017

Int Arch Allergy Immunol

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Background: Few studies assessing the use of epinephrine in drug-induced anaphylaxis (DIA) in the hospital setting are available. We utilized the Beijing Pharmacovigilance Database (BPD) to evaluate the appropriateness of epinephrine for DIA management. Methods: DIA cases collected in the BPD from January 2004 to December 2014 were adjudicated and analyzed for demographics, causative drugs, clinical signs, outcomes, initial treatment, route, dosing, and cardiovascular adverse events (CAE) of epinephrine. Results: DIA was primarily caused by antibiotics (38.4%), radiocontrast agents (11.9%), traditional Chinese medicine injections (10.9%), and chemotherapeutic drugs (10.3%). Only 708 (59.5%) patients received epinephrine treatment. Patients who received epinephrine were more likely to experience wheezing (p < 0.001) and respiratory arrest (p < 0.001). Among 518 patients with a complete record of the epinephrine administration route, the percentage of patients receiving it by intramuscular (IM) injection, subcutaneous (SC) injection, intravenous (IV) bolus injection, or IV continuous infusion was 16.9, 31.5, 43.5, and 8.1%, respectively. Among the 427 patients with a record of both the administration route and the dosing, an overdose was more likely with IV bolus (94.1%) in contrast to IM injection (56.6%; p < 0.001) or SC injection (43.7%; p < 0.001). Among the patients analyzed for CAE (n = 349), 17 patients accounted for 19 CAE, and 13 (76.5%) of these patients were overdosed with epinephrine. Conclusion: Underuse, inappropriate IV bolus use, and overdosing were the 3 major problems with epinephrine use in DIA in China. Educational training for health care professionals on the appropriate use of epinephrine in managing anaphylactic reactions is suggested.

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Section: Methodsmentioning

confidence: 99%

Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the Beijing Pharmacovigilance Database

Wang

Ma²,

Xing

et al. 2017

Int Arch Allergy Immunol

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“…These include the Advanced Pediatric Life Support (APLS) formula,1 the Broselow Tape technique,2 the Argall formula developed in Manchester,3 UK and the Best Guess formulae4 derived in Brisbane, Australia. The age-based formulae (APLS, Argall, Best Guess) are summarised in table 1.…”

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confidence: 99%

Parental weight estimation of their child's weight is more accurate than other weight estimation methods for determining children's weight in an emergency department?

Krieser

Nguyen

Kerr

et al. 2007

Emergency Medicine Journal

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Objective: To compare the various paediatric weight estimation methods (Advanced Pediatric Life Support, Broselow Tape, Argall, and Best Guess) and parental estimate to measured weight. Patients and method: A convenience sample of children aged 1-11 years who presented to the emergency department over a 6 month period were eligible for inclusion. Data collected included height, age, ethnicity, parent estimate of weight and measured weight. Body mass index (BMI) was calculated. The outcome of interest was agreement between estimated weight and measured weight for each method. Data were analysed by descriptive statistics and performance of each weight estimation method was compared using mean difference (MD), root mean square error (RMSE) and agreement within 10%. Results: 410 cases were included in this study. The median age was 4 years, there were more boys (54.4%), and the majority of cases were of Caucasian ethnicity (74.9%). The mean BMI of the sample was 17 kg/m 2 and mean actual weight was 21.2 kg. Parent estimate was the most accurate method with 78% of parent estimates within 10% of measured weight and the lowest mean difference (20.6 kg) and RMSE (3.1 kg). The Broselow tape was the most accurate of the other methods, with 61% of estimations within 10% of measured weight. Conclusion: Parental estimation of weight is more accurate than the other weight estimation methods studied. When this is not available, the Broselow tape is the most accurate alternative method.

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“…in Australia have proposed three linear equations to estimate pediatric weight, presented as: for infants < 12 months: Weight (kg) = (age in months+9)/2; for children aged 1-5years: Weight (kg) = (age in years + 5)x2; for children aged 5-14 years: Weight= age in years x 4. This formula may be more accurate than the APLS classical formula [8]. In comparison with several weight prediction methods, Krieser and al found parent estimation more accurate than several methods [7].…”

Section: Discussionmentioning

confidence: 99%

“…Several methods have been proposed based on age, length-weight relationships, foot or mid-arm size, clinician experience or parent estimate [3][4][5][6][7][8][9][10]. We focused this study on the APLS age-based weight estimation formula "weight = (age + 4) × 2", to check its performance for weight calculation in malian children attending anesthetic evaluation.…”

Section: Introductionmentioning

confidence: 99%

A Local Validation of the APLS Pediatric Age-Based Weight Estimation Formula

2017

JACCOA

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Objective: Authors aimed to check the accuracy of the Advanced Paediatric Life Support (APLS) pediatric weight estimation formula (Weight in kg = (Age in year +4) x 2) in Mali. This formula has been proposed for weight estimation if direct measurement is not available, but its accuracy has been discussed in some studies. Method:It was a retrospective analysis of anesthetic files. Collected data were age, gender, the ASA status, actual weight and estimated weight. Statistical analysis was performed with SPSS 20, using the Wilcoxon test and Spearman coefficient.Results: Seven hundred and twenty four children were included, with a mean age of 71,07 ±47,98 months. Mean measured weight was 20,09±8,56 kg versus 19,85±7,99 kg for the formula based estimated weight (p<0,001). Actual weight were concordant with estimated one in 61,46% of cases. The estimation error was 13,86% to 40,34% of measured weight in the 1 to 10 years old children, while it was from -11 to +15 kg in children over 10 years old. Conclusion:The APLS formula was accurate in 61,46%, and seems to be applicable for 1 to 10 years old children.

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Make your Best Guess: An updated method for paediatric weight estimation in emergencies

Abstract: The present study devised an age-based method for paediatric weight estimation which should more accurately predict weight than the widely used APLS formula.

Cited by 75 publications

References 10 publications

Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the Beijing Pharmacovigilance Database

Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the Beijing Pharmacovigilance Database

Parental weight estimation of their child's weight is more accurate than other weight estimation methods for determining children's weight in an emergency department?

A Local Validation of the APLS Pediatric Age-Based Weight Estimation Formula

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