The RAMA Ped Card: Does it work for actual weight estimation in child patients at the emergency department

doi:10.5847/wjem.j.1920-8642.2017.02.008

Abstract

Abstract:

BACKGROUND: In emergency conditions, the actual weight of infants and young children are essential for treatments. The RAMATHIBODI Pediatric Emergency Drug Card or RAMA Ped Card has also been developed to estimate actual weight of the subjects. This study aimed to validate the RAMA Ped Card in correctly identifying the actual weight of infants and young adults.

METHODS: This study was a prospective study. We enrolled all consecutive patients under 15 years of age who visited the emergency department (ED). All eligible patients' actual weight and height were measured at the screening point of the ED. The weight of each patient was also measured using the unlabeled RAMA Ped Card. The Cohen's kappa values and agreement percentages were calculated.

RESULTS: During the study period, there were 345 eligible patients. The RAMA Ped Card had a 61.16% agreement with the actual weight with a kappa of 0.54 (P<0.01), while the agreement with the actual height had a kappa of 0.90 and 91.59% agreement. Sub-group analysis found kappa scores with good range in two categories: in cases of accidents and in the infant group (kappa of 0.68 and 0.65, respectively).

CONCLUSION: The RAMA Ped Card had a fair correlation with the actual weight in child patients presenting at the ED. Weight estimation in infant patients and children who presented with accidents were more accurate.

Key words: Child, Weight estimation, Card, Kappa

Thavinee Trainarongsakul, Pitsucha Sanguanwit, Supawan Rojcharoenchai, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha. The RAMA Ped Card: Does it work for actual weight estimation in child patients at the emergency department[J]. World Journal of Emergency Medicine, 2017, 8(2): 126-130.

Figures/Tables 5

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References 18

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Band number	Color	Estimated actual weight (kg)
1	Blue	3-5
2	Green	6-7
3	Yellow	8-9
4	Light pink	10-11
5	Navy blue	12-14
6	Orange	15-18
7	Dark pink	19-22 (19-23.99)^*
8	Purple	24-28 (24-29.99)^*
9	Brown	30-36

Factors	Number (%)
Sex
Male	192 (55.65)
Female	153 (44.35)
Age group
Infant	66 (19.13)
Preschool	168 (48.70)
Primary school	111 (32.17)
Median actual weight, kg (min, max)	14.10 (3.30, 49.60)
Mean actual height, cm (SD)	97.01 (24.14)
Underlying disease
Yes	144 (41.74)
No	201 (58.26)
Current medication
Yes	118 (34.20)
No	227 (65.80)
Presenting disease
Accidents	36 (10.43)
Non-accident	309 (89.57)
Level of emergency
Emergent	2 (0.58)
Urgent	174 (50.43)
Non-urgent	169 (48.99)
Treatment at the ED
Yes
Bronchodilator	37 (10.73)
IV fluid	33 (9.56)
IV/oral medications	258 (74.78)
No	17 (4.93)
Discharge status
Admitted	67 (19.42)
Discharged	266 (77.10)
Referred	12 (3.48)

Outcomes	Number (%)
Concordance with actual weight	211 (61.16)
Under the actual weight	70 (20.29)
Over the actual weight	64 (18.55)
Concordance with actual weight ± one band error	335 (97.10)

Features	% agreement	Kappa values	P values
Level of emergency
Emergent	59.09	0.53	<0.01
Non-emergent	59.17	0.53	<0.01
Disease type
Accidents	72.22	0.68	<0.01
Non-accident	57.61	0.52	<0.01
Age groups
Infants	75.76	0.65	<0.01
Pre-school age	54.76	0.40	<0.01
School age	55.86	0.42	<0.01

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