title: Paediatric analgesia in the emergency department, are we getting it right?
abstract: OBJECTIVE
  To measure the dose discrepancy in prescribing simple paediatric analgesia, in the emergency department, by comparing age and actual weight-based dosing. To establish the accuracy of the weight-estimation formula for children [weight kg=2 (age years+4)].
  
  
  METHODS
  A prospective survey conducted in the emergency departments of a UK teaching hospital and district general hospital. Two hundred and forty-seven children were prescribed simple analgesia in the form of paracetamol and ibuprofen or both. The dose prescribed was based on age. All children were weighed and a maximum dose based on the child's weight was calculated. The individual child's weight was also compared with the weight calculated using the estimation formula.
  
  
  RESULTS
  A total of 247 patients were included. Two hundred and thirty-three patients were prescribed paracetamol. Fifteen patients were prescribed ibuprofen. The paracetamol group was administered a mean dose that was 67% (P<0.001) of the optimal dose that was based on weight. Ibuprofen dosage was 51% (P<0.001) of optimal dose. The weight-estimation formula underestimated weight by 16% (P<0.001).
  
  
  CONCLUSIONS
  Prescribing analgesia by age often results in significant underdosing in the paediatric population. Predicting a child's weight using the calculation may result in underdosing.
authors.affiliation: Accident and Emergency, Ninewells Hospital, Dundee, Scotland, UK. colin.donald@tuht.scot.nhs.uk
authors.forename: Colin
authors.initials: C
authors.lastname: Donald
authors.forename: Russell
authors.initials: R
authors.lastname: Duncan
authors.forename: Lorraine
authors.initials: L
authors.lastname: Blair
authors.forename: Shobhan
authors.initials: S
authors.lastname: Thakore
authors.forename: Michael
authors.initials: M
authors.lastname: Clark
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000367:Age Factors; D000698:Analgesia / Q000379:methods*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D010372:Pediatrics / Q000592:standards*; D011446:Prospective Studies; D012606:Scotland
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D007052:Ibuprofen