359 - Comparing the Accuracy of Different Weight Estimation Modalities in the Pediatric Emergency Department
Monday, May 1, 2023
9:30 AM – 11:30 AM ET
Poster Number: 359 Publication Number: 359.404
Aadil Rahman, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Heather Territo, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Taylor Goodman, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Brian Wrotniak, John R. Oishei Children's Hospital, Buffalo, NY, United States; haiping Qiao, UBMD Pediatrics, Buffalo, NY, United States
Pediatric Emergency Medicine Fellow Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo Buffalo, New York, United States
Background:
Background: Effective medical management of pediatric patients relies upon weight-based measurements and dosing. In critical situations when weight cannot be safely obtained on the scale, such as during traumas or resuscitations, weight must be estimated. Conventional estimation methods include Emergency department (ED) provider estimate, parent estimate, and length-based tapes. The Broselow Tape, the most well-known method, can be inaccurate in low and high socioeconomic (SE) settings.1 The PAWPER-XL MAC is a newer method that includes mid-arm circumference as a surrogate marker for body habitus and has demonstrated greater accuracy in low SE populations.2 Objective: The primary aim of this study is to assess the accuracy of the PAWPER-XL MAC compared with other conventional weight estimation methods in the United States. Design/Methods: Methodology: This was a prospective observational study performed in a single tertiary-care Pediatric Emergency Department over a 6-month period. Patients between the ages of 0-18 years who were able to be weighed on a scale were enrolled. Measurements obtained for each patient included scaled weight, parent estimation of weight, provider’s estimation of weight, and weight estimation using Broselow, PAWPER XL, and PAWPER-XL-MAC tapes. Each weight estimation modality was compared against the measured scaled weight. Results:
Results: 224 patients were enrolled. All patients had a scaled weight and weight estimations documented. The PAWPER-XL MAC accurately estimated weight within 10% of actual weight (p10) 65.2% of the time. The PAWPER, Broselow and ED provider p10 estimations were 55.4%, 53.1% and 49.1%, respectively. Parent estimate was the most accurate method with a p10 of 71.9%.
Conclusion(s):
Conclusions: The PAWPER-XL MAC tape is an accurate, efficient and generalizable tool to estimate pediatric weight. Parent estimate, however, is the most accurate technique. Our results suggest that in critical situations where scaled weight measurement cannot be readily obtained, parental estimation of their child’s weight can be accurate and trusted. If a parent is unavailable, the PAWPER-XL MAC is the best alternative. The ED provider estimation is the least accurate method and should not be readily relied upon to make critical management decisions.
