Estimating the weight of children in Nepal by Broselow, PAWPER XL and Mercy method

doi:10.5847/wjem.j.1920-8642.2018.04.007

Abstract

Abstract:

BACKGROUND: Resuscitation of a critically-ill child requires an accurate weight for fluids and medication dosing; however, weighing children on a scale while critically ill is not always practical. The objective of this study is to determine the accuracy of three different weight estimation methods (Broselow, PAWPER XL and Mercy tape) of children presenting to Patan Hospital, Nepal.
METHODS: This was a prospective, cross-sectional study that included children presenting to the emergency department and under-fourteen outpatient clinic at Patan Hospital. Measured weight was compared to estimated weight of Broselow, PAWPER XL, and Mercy tapes. The mean percentage error and percentage of estimated weights that were within 10% (PW10) and 20% (PW20) of actual weight were calculated. Acceptable accuracy was determined as a PW10>70% and PW20>95%. A Bland-Altman analysis was done to determine agreement between each weight estimation method and actual weight.
RESULTS: The study included 813 children. The mean age was 4.2 years (ranging from 4 days to 14 years) with 60% male. The mean percentage error (MPE) for Broselow, PAWPER XL and Mercy were -1.0% (SD 11.8), 0.7% (10.5) and 4.2% (11.9) respectively. The predicted weight within 10% was highest for the PAWPER XL (71.5%) followed by Broselow (63.2%) and Mercy (58.1%). The predicted weight within 20% of actual weight was 95.2%, 91.5% and 91.3% for PAWPER XL, Broselow and Mercy respectively.
CONCLUSION: The PAWPER XL tape was the only method found to be accurate in estimating the weight of Nepalese children.

Key words: Child, Resuscitation, Anthropometry, Nepal

Karun Shrestha, Prakriti Subedi, Oshna Pandey, Likhita Shakya, Kailash Chhetri, Darlene R. House. Estimating the weight of children in Nepal by Broselow, PAWPER XL and Mercy method[J]. World Journal of Emergency Medicine, 2018, 9(4): 276-281.

Figures/Tables 3

Table 1

Table 2

Figure 1.

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Parameters	All	≤12 kg	12.1-20 kg	>20 kg	HS<3	HS=3	HS>3
Total, n	813	398	194	221	335	425	53
Males, n	488	236	120	132	183	262	43
Females, n	325	162	74	89	152	163	10
Age (years), mean (SD)	4.2 (4.1)	1.0 (1.0)	4.1 (1.8)	10.0 (2.4)	5.0 (4.0)	3.5 (4.0)	4.6 (4.9)
Weight (kg), mean (SD)	15.8 (10.2)	8.2 (2.2)	15.3 (2.3)	30.0 (8.0)	16.4 (8.6)	14.7 (10.1)	21.7 (16.3)

Parameters	Broselow tape	Pawper XL tape	Mercy method
All
MPE (SD)	-1.0 (11.8)*	0.7 (10.5)	4.2 (11.9)
RMSPE	11.8	10.6	12.7
PW10	63.2	71.5	58.3
PW20	91.7	95.2	91.3
≤12 kg
MPE (SD)	-0.41 (12.1)	0.7 (12.4)	4.5 (13.1)
RMSPE	12.1	12.4	13.8
PW10	61.6	64.1	51.5
PW20	92.0	92.5	90.2
12.1-20 kg
MPE (SD)	-1.9 (10.2)	1.1 (8.3)	3.1 (10.9)
RMSPE	10.3	8.4	11.3
PW10	68.6	80.9	66.0
PW20	93.8	97.4	93.3
>20 kg
MPE (SD)	-1.4 (12.7)	0.3 (8.5)	4.8 (10.5)
RMSPE	12.7	8.5	11.5
PW10	61.5	76.5	63.8
PW20	88.8	98.2	91.4
HS<3
MPE (SD)	-6.1 (10.1)	-0.4 (10.1)	5.8 (12.8)
RMSPE	11.8	10.1	14.1
PW10	61.6	76.1	52.2
PW20	92.2	96.7	89.6
HS=3
MPE (SD)	0.8 (10.5)	0.5 (10.6)	2.9 (11.3)
RMSPE	10.5	10.7	11.7
PW10	69.7	69.9	62.6
PW20	93.6	94.4	92.2
HS>3
MPE (SD)	16.5 (11.1)	8.6 (9.1)	4.4 (9.7)
RMSPE	19.8	12.6	10.7
PW10	22.0	55.8	63.5
PW20	72.0	94.2	96.1