The PAWPER tape and the Mercy method outperform other methods of weight estimation in children at a public hospital in South Africa.
BACKGROUND
A rapid, accurate weight-estimation method is essential in paediatric emergency care, when it may not be possible to weigh a child, as drug dose calculations cannot be completed without weight.


OBJECTIVE
To determine and compare the performance of the Broselow tape, PAWPER (Paediatric Advanced Weight Prediction in the Emergency Room) tape, Mercy method, Wozniak method and three age-based formulae in estimating the weight of children. A secondary objective was to assess whether the addition of a figural rating scale to assess body habitus improved the performance of the PAWPER tape.


METHODS
We estimated the weights of children between the ages of 1 month and 12 years using the Broselow tape, PAWPER tape, Mercy method and Wozniak method. The performance of the four methods was evaluated, and they were compared with one another and with three aged-based formulae.


RESULTS
Three hundred children were enrolled in the study. The PAWPER tape and Mercy method performed the best, estimating weight within 10% of actual weight (PW10) in 88% and 80% of cases, respectively. The Broselow tape and Wozniak method fared significantly worse (PW10 54% for Broselow, 71% for the ulna length method and 63% for the tibia length method). The use of a figural rating scale to assess body habitus did not significantly improve the overall performance of the PAWPER tape. The age-based formulae performed poorly.


CONCLUSIONS
The PAWPER tape and Mercy method outperformed the Wozniak method and Broselow tape in estimating weight of children. The Broselow tape and the age-based formulae were very poor weight-estimation methods and should no longer be used, given the availability of better methods.
Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. vanessa.greyling@gmail.com.
Vanessa G
VG
Georgoulas
Mike
M
Wells