Analysis of Parental Estimates of Children's Weights in the ED,☆☆,

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Abstract

Study objective: To assess the ability of parents to estimate their children's weight. Methods: We assembled a convenience sample of children, newborn to 5 years, who presented to the ED of a tertiary care hospital. Each child's mother or father was asked to estimate the child's weight as accurately as possible. The triage nurse then weighed the child on an electronic scale. An age-based formula was also used to estimate the child's weight. The parental estimate and the formula-based weight were compared with the weight indicated on the scale. Results: One hundred seventeen children were enrolled. The mean age was 26.7 months (range, newborn to 60 months). We analyzed agreement by plotting the percent difference between the weight estimates against the actual weights. The mean±SD difference between the parental estimate and the actual weight was 6.8%±9.8%. Parental estimates were accurate to within 10% of the measured weight in 80% of the cases (94 of 117). The mean±SD difference between the formula-derived weight and the actual weight was 13.6%±17.5%. The formula was accurate to within 10% of the measured weight in 46% of cases (54 of 117). Conclusion: In 80% of cases, the parental estimate of the child's weight was within 10% of the measured weight. The parental estimate was more accurate than the formula-derived weight. [Leffler S, Hayes M: Analysis of parental estimates of children's weights in the ED. Ann Emerg Med August 1997;30:167-170.]

Section snippets

INTRODUCTION

Rapid estimation of pediatric weights is a skill required of all emergency health care providers. Methods include the Broselow tape,1 age-based formulas,2 and—when available and practical—an actual measured weight. In this study we assessed the accuracy of the parents in providing a weight. If found reliable, such weights could be used by prehospital and hospital providers to help estimate the degree of dehydration, assess failure to thrive, and calculate medication dosing.

MATERIALS AND METHODS

We assembled a convenience sample of children, newborn to 5 years, who presented to our ED with their parents between February 1 and March 3, 1996. Children who arrived by ambulance were not included. On the child's arrival at the triage desk, vital signs were recorded and the parent was asked for consent to the child's enrollment in the study. If the parent agreed, he or she was asked to estimate the child's weight. The child was then weighed on a Detecto electronic scale, and the weight was

RESULTS

We enrolled 117 patients in the study. Their mean age was 26.7 months (range, 5 days to 60 months). An analysis of agreement was used to compare measured weights with parental estimates and formula-derived weights. We converted differences to percentages of the actual weights. The mean±SD difference between the estimated weight and the measured weight was 6.8%±9.8%. The mean±SD difference between the formula-derived weight and the measured weight was 13.6%±17.5%. Figure 1 shows the percent

DISCUSSION

In this study 80% of parents were accurate to within 10% of the measured weight in estimating their children's weight. The parental estimate performed much better than the age-derived formula. In a previous study, values calculated with the Broselow tape were found to be within 15% of the actual weight in 79% of cases.1 Our findings indicate that parents are another accurate and reliable source of information for weight estimation. This information is especially useful in situations such as

References (4)

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    The Broselow tape method of estimating pediatric weight is commonly used in the United States [1]. Using a parent's estimate of the child's weight has also been described [2-4]. Both methods have outperformed age-based formulas [5].

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    We were also unable to identify the source of the weight estimate, any resources used, or the method in which the estimate was made. Several studies have shown that parental estimates are more accurate than other methods of assessing children’s weights [13-15]. We were unable to directly ascertain the presence of a parent and whether they provided the weight estimate; however, encounters at home, a surrogate measure of parental presence, was not associated with the accuracy of weight estimates.

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From the University of Vermont College of Medicine, Burlington, VT.

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Reprint no.47/1/82889

Address for reprints: Stephen Leffler, MD, FAHC Emergency Department, Colchester Avenue, Burlington, VT 05401

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