A Comparison of Paediatric Weight Estimation Methods for Emergency Resuscitation

Study Overview
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Brief Summary
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The purpose of this study is to study the validity, reliability and practicality of the different weight estimation methods (parent estimation method, Mercy method, Broselow tape, original and update APLS) in Thai children.

Detailed Description
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A reliable paediatric weight estimation method is crucial for the physician attempting to resuscitate an injured child. When a patient is in a critical, life threatening condition or in mass casualty settings, actual body weight cannot be obtained by weight measurement instrument. Several resuscitation modalities, such as resuscitation medications, fluid replacement, and amount of electrical shock in defibrillation, are calculated according to patient body weight Besides from weight derived from children's parent which cannot achieve in some situations and vary in accuracy, Broselow tape is the gold standard currently for appraise children's weight from their length. However, this tape tends to underestimate weight and it is limited to use in children are less than 146 centimeters in length. Age- based weight estimation methods are the mathematical formulas to estimate weight from the children's age. The various methods described in the Advanced Paediatric Life support (APLS) both original and updated still have doubts about the accuracy and reliability. Both length- based and aged- based methods fail to resolve the overweight or obese and underweight children who have the same height or the same age. Mercy method is the new weight estimation method that incorporates the humeral length and mid-upper arm circumference to estimate the child weight. This method has been demonstrated both accuracy and reliability over other existing methods. This study will evaluate the validity, reliability and practicality of the previously mentioned pediatric weight estimation methods.

Official Title
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A Comparison of Paediatric Weight Estimation Methods for Emergency Resuscitation

Conditions
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Body Weight

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy children Informed consent and assent (7-12 years) were obtained Exclusion Criteria: Disabling children Incapable to stand up or lie down to measure weight or length Chronic steroid use Edema from known diseases Extremities joint contracture

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The validity of the different weight estimation methods | The performance of the Mercy method, Broselow tape, parental estimation and aged-base methods (original APLS,updated APLS formula) were compared against the actual weight and against each other. Agreement between estimated weight and actual weight of each weight estimation method was determined by Bland-Altman plots with 95% limits of agreement and correlation test. Bias and variability tested by calculate error : predicted weight -actual weight, calculated percentage error : [(predicted - actual weight) x 100%] / actual weight, calculated root mean square error = square root of the average squared error. Categorical error analysis was done by the percentage error of each of the estimation techniques within 10% and 20% of actual weight. | at time of measurement within one day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The reliability of the different weight estimation methods | The inter-rater reliability compared the results between two raters. The intra-rater reliability was compared the results from first and second measurement in one rater.The value was tested by intra- class correlation coefficient that a value > 0.8 was considered to excellent correlation. | at time of measurement within one day | 
| The practicality of the different weight estimation methods | User satisfaction was evaluated from questionnaire and the values were analysed by descriptive statistics. Time from start measurement until get the estimated weight was recorded in all methods (except in parental estimation method) to calculate median time measurement. | at time of measurement within one day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Body Weight, Resuscitation, Pediatric weight estimation