Can Canadian paramedic students accurately estimate pediatric patient weight?

Abstract

Introduction: Paramedics are expected to have the ability to estimate pediatric patient weight as a means of determining weight-based medication doses. In order to ensure accuracy in medication administration, it is essential for these estimations to be accurate. The objective of this study was to determine if Canadian paramedic students could accurately estimate the weight of pediatric patients.

Methods: A prospective single-blinded observational pilot study was conducted. Paramedic students were instructed to estimate the weight of ten pediatric subjects. Subjects were displayed in images showing one frontal and one lateral view, each with a common item for size reference.

Results: A total of 67 paramedic students participated in the study. The findings highlighted large variance in the ability of paramedic students to accurately estimate patient weight. On average 62.4% fell within +/-20% of the true measure. Most weight estimations were underestimated. There were no significant differences demonstrated between the estimation abilities of 1st year and 2nd year students.

Conclusion: Paramedic students were not able to estimate pediatric patient weight with a high degree of accuracy. The results highlight the difficulties faced by students in estimating pediatric weights. There may be a need to provide further education and tools for paramedic students in this area.

Full text

Background Problem / Question
The safe administration of medications
to patients is an important part of
paramedic practice.
Pediatric medication doses are
generally calculated based on patient
weight.
In the absence of a known weight,
paramedics must rely on measurement
tools, such as the Broselow tape.
These methods can be unreliable in
certain populations, and are not
available to all paramedics.
Paramedics are taught several
methods for estimating pediatric
weight, including various age-based
formulae.
Previous studies have demonstrated
that paramedics find estimation of
pediatric weights challenging, and their
estimation abilities are often
inaccurate.
These inaccurate weight calculations
may lead to under-or over-dosing of
patients.
This study aimed to explore Canadian
paramedic students abilities related to
pediatric weight estimation.
67 students participated in the study; 39
first years and 28 second years.
There was no statistically significant
difference in estimation accuracy
between first-year and second-year
students with the exception of one
subject (Subject A) (Fig. 1)
Second-year students underestimated
weight in 7/10 subjects whereas first-
year students underestimated weight in
5/10 subjects.
18.8% of estimations made were within
±5% range of actual weight, 38.4%
within ±10% range, and 62.4% within
±20% range (Fig. 2)
Paramedic students demonstrated variance and inaccuracy in the estimation of
pediatric weights using combinations of observation and age-based calculations.
These results are consistent with existing findings in Australian paramedic students.
Our results suggest that paramedic students, and potentially practicing paramedics
may benefit from improved methods for estimation of pediatric weights.
Figure 1. Weight estimations of pediatric patients by participant groups
Figure 2. Overall accuracy of weight estimation
Objective
Prospective observational study of
paramedic students at Fanshawe
College, Ontario, Canada.
Ethics approval was received from
Fanshawe College REB.
Participants were asked to estimate
pediatric weight based on photos of 10
pediatric patients whose weights were
known to the researchers.
Methods
Can Canadian paramedic students accurately estimate pediatric weight?
Scott Bernaerts BA(Hons.) BEd, Jesse Shelton BSc, Emily Weston BPHE(Hons.) BEd, Eric Demers,
Jordan Miller BA(Hons.), Tristan van der Groef, Alan M. Batt MSc PhD(c)
Paramedic Programs, Fanshawe College, Ontario, Canada.
Conclusion
Results
Subject A Subject B Subject C Subject D Subject E Subject F Subject G Subject H Subject I Subject J
First year student mean estimation 30.71 22.57 65.14 14.78 53.34 17.06 39.27 20.95 35.33 33.49
Second year student mean estimation 27.53 20.99 60.61 14.65 51.53 17.11 25.79 20.39 33.45 33.90
Actual weight of subject 37.0 21.7 73.9 13.3 52.9 17.0 33.2 23.3 39.6 39.4
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
Weight in kg
0
10
20
30
40
50
60
70
80
90
100
Subject A Subject B Subject C Subject D Subject E Subject F Subject G Subject H Subject I Subject J
% of estimates made within range of actual weight
5% range of actual weight 10% range of actual weight 20% range of actual weight
Subject Actual
(kg)
Mean (kg)
Min (kg)
Max (kg)
A37.0 29.33 17.24 45.36
B21.7 21.88 13.61 31.75
C73.9 63.18 32.00 85.00
D13.3 14.72 8.16 22.68
E52.9 52.56 30.00 74.84
F17.0 17.09 9.07 27.22
G33.2 37.77 15.88 56.70
H23.3 20.71 11.34 36.29
I39.6 34.52 20.41 49.90
J39.4 33.67 19.50 50.00