Original ContributionCan ED staff accurately estimate the weight of adult patients?
Introduction
Estimation of the weight of pediatric patients has been well studied, including several descriptions of visual estimation rules and various devices based on length or other quickly measurable parameters [1], [2], [3], [4], [5], [6], [7]. However, adult weight estimation has not been studied nearly as well. A few articles in the last decade have examined the accuracy of adult weight estimates made in the prehospital or operative setting [8], [9], [10], [11]. Recent articles have begun to address this issue in the emergency department (ED) setting [12], [13], [14], [15], [16]. However, there is still limited understanding of the effect of body mass index (BMI) on the resultant estimate; in other words, is an adult who is unusually heavy or light for his or her size more likely to have his or her weight inaccurately estimated? In addition, previous studies have suffered from an insufficient sample size.
We sought to address these issues in a large, prospective, observational trial.
Section snippets
Study design
This was a prospective, observational cohort study of adults presenting to our ED over a 7-month period. Our Institutional Review Board approved the study as an exempt protocol before patient enrollment. Because of the low-risk nature of the weight estimations, the Institutional Review Board waived informed consent in lieu of providing study information sheets and obtaining verbal consent to be weighed.
Study setting and population
This study took place in the ED of a suburban university tertiary referral center with an
Results
A total of 96 staff members and 250 patients were enrolled; 975 total estimates were obtained. To control for both staff and patient, our data analysis required that we exclude analyses with only 1 associated estimate. Accordingly, 9 staff members were excluded from analysis. Nine patients were also excluded; 2 of these patients had 2 estimates each before the staff exclusion. Our final data set therefore consisted of 87 staff members, 241 patients, and 957 estimates.
The mean estimate was 98%
Discussion
Providers were within 5% of measured weight on 33% of overall estimates and within 10% of measured weight on 63% of overall estimates. Only the BMI proved to be a statistically significant factor in contributing to error of measurement.
To place our results in more clinical terms, we looked at 2 clinical scenarios. First, we searched for instances where an incorrect weight estimate would have sent a dangerously heavy patient to the computed tomographic scanner or, conversely, would have
Acknowledgment
The authors acknowledge the UC Irvine Emergency Medicine Research Associates Program students for their assistance in patient and staff enrollment.
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