title: Estimating the weight of ethnically diverse children attending an Australian emergency department: a prospective, blinded, comparison of age-based and length-based tools including Mercy, PAWPER and Broselow.
abstract: OBJECTIVE
  To prospectively compare the actual weights of Australian children in an ethnically diverse metropolitan setting with the predicted weights using the Paediatric Advanced Weight Prediction in the Emergency Room (PAWPER) tape, Broselow tape, Mercy system and calculated weights using the updated Advanced Paediatric Life Support (APLS), Luscombe and Owens and Best Guess formulae.
  
  
  METHODS
  A prospective, cross-sectional, observational, blinded, convenience study conducted at the Children's Hospital at Westmead Paediatric Emergency Department in Sydney, Australia. Comparisons were made using Bland-Altman plots, mean difference, limits of agreement and estimated weight within 10% and 20% of actual weight.
  
  
  RESULTS
  199 patients were enrolled in the study with a mean actual weight of 27.2 kg (SD 17.2). Length-based tools, with or without body habitus adjustment, performed better than age-based formulae. When measuring estimated weight within 10% of actual weight, PAWPER performed best with 73%, followed by Mercy (69%), PAWPER with no adjustment (62%), Broselow (60%), Best Guess (47%), Luscombe and Owens (41%) and revised APLS (40%). Mean difference was similar across all methods ranging from 0.4 kg (0.0, 0.9) for Mercy to -2.2 kg (-3.5, -0.9) for revised APLS. Limits of agreement were narrower for the length-based tools (-5.9, 6.8 Mercy; -8.3, 5.6 Broselow; -9.0, 7.1 PAWPER adjusted; -12.1, 9.2 PAWPER unadjusted) than the age-based formulae (-18.6, 17.4 Best Guess; -19.4, 15.1 revised APLS, -21.8, 17.7 Luscombe and Owens).
  
  
  CONCLUSIONS
  In an ethnically diverse population, length-based methods with or without body habitus modification are superior to age-based methods for predicting actual body weight. Body habitus modifications increase the accuracy and precision slightly.
authors: Emergency Department, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.|Disciplines of Emergency Medicine and Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors: Fenton
authors: http://orcid.org/0000-0002-5365-2462
authors: F
authors: O'Leary
authors: Emergency Department, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.|Disciplines of Emergency Medicine and Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors: Blessy
authors: B
authors: John-Denny
authors: Disciplines of Emergency Medicine and Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors: Kathryn
authors: K
authors: McGarvey
authors: Emergency Department, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
authors: Alexandra
authors: A
authors: Hann
authors: Emergency Department, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.|Disciplines of Emergency Medicine and Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors: Ioannis
authors: I
authors: Pegiazoglou
authors: Australian Catholic University, Sydney, New South Wales, Australia.
authors: Jennifer
authors: J
authors: Peat
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D000886:Anthropometry / Q000295:instrumentation / Q000379:methods; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000208:ethnology / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D015588:Observer Variation; D011446:Prospective Studies
keywords: Body weight; Resuscitation; ethnology