Which paediatric weight formula is best suited for the out-of-hospital field?

Background: Weight estimation in pre-hospital paediatric emergencies is often required for the calculation of drug dosages, fluid therapy and defibrillation. In the pre-hospital field the treatment of a patient needs to occur in a timely and accurate fashion, this necessity drives the need for an accurate weight estimation formula. The objective of this study was to identify a paediatric weight estimation formula relevant to the pre-hospital field.Methods: A literature review was undertaken using a variety of electronic medical databases from their commencement date until the end of May 2012. Keywords used in the search included: Weight estimation, drug calculations, pediatric, paediatric, EMS, EMT, paramedic, emergency medical service, emergency medical technician, pre-hospital, out-of-hospital and ambulance. The keywords were used individually and in combination. The inclusion criterion was any study type that described the development or evaluation of a paediatric weight calculation in the pre-hospital or hospital setting.Findings: There were 635 articles located with 25 meeting the inclusion criteria. The commonly used APLS weight estimation formula significantly underestimates a child’s weight. The best guess formula appears to be more accurate at estimating the weight; however more research needs to be conducted to validate this method for the pre-hospital field.Conclusion: As the average weight of children increases, the accuracy of weight estimation formulas decreases, suggesting that these methods will be unable to sufficiently adjust to deal with future rises in average weights of children. Further research is required to determine the most appropriate formula for paramedics to use in the pre-hospital setting.

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