A new study pointed out that little is known about the relative accuracy of different methods currently used to weigh patients during emergency care.
Researchers from Florida Atlantic University’s (FAU) Schmidt College of Medicine led the effort, suggesting that the ideal method of weight estimation should be accurate, quick, and easy to use in the ED, the ICU, or the prehospital environment. Being inexpensive and requiring minimal training for effective use also are desirable, they said.
In order to better understand what is being done now, the study team conducted a systematic review. The results were published in the American Journal of Emergency Medicine.
The researchers reviewed 95 studies in which 27 different methods of total body weight estimation were described; 42 studies were included in the meta-analysis.
The authors determined that the most accurate methods of estimating weight in EDs involved three-dimensional (3D) camera system estimates (88.8% accuracy); patient self-estimates (88.7% accuracy); the Lorenz method designed for use for dose calculations for thrombolysis in stroke patients, which measures hip and abdominal circumferences (77.5%); and family member estimates (75%). However, no method was without significant potential limitations during emergency care, the researchers pointed out.
“Patient self-estimations of weight were generally very accurate and should be the method of choice during emergency care, when possible,” said senior author Mike Wells, PhD, a research assistant professor in the Department of Emergency Medicine at FAU. “However, since alternative estimation methods must be available when confused, or otherwise incapacitated, patients are unable to provide an estimate, alternative strategies of weight estimation also should be available.”
One finding of the review was that healthcare-provider estimates are quite often unreliable, no matter who was doing the estimating.
“During emergency care, it is necessary to estimate weight to allow for drug dose calculations, fluid volume calculations, mechanical ventilation settings, and other weight-based interventions,” said coauthor Richard D. Shih, MD, a professor of emergency medicine. “In order to ensure the efficacy of the drug therapy, while avoiding harm from overdose, the weight estimation should be as accurate as possible.”
The researchers found significant promise in methods such as weight estimation using 3D camera systems. “Many of the methods of weight estimation we reviewed had potential for failure or reduced accuracy during emergency care, and the ideal method for use during emergencies still needs to be determined in future prospective studies,” Dr. Wells said. “The significance of our research lies in its provision of the currently available information on this topic with the aim to offer guidance to clinicians and researchers in this matter of important patient safety.”
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