Paediatric weight estimation: validation of the PAWPER XL tape mid-arm circumference method in a South African Hospital

Wu, Ming-Tung
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Objective To prospectively compare the performance of the Broselow tape, Mercy method, PAWPER XL tape and the PAWPER XL-MAC method in estimating children’s weight in a population of children from a low-income setting. The secondary outcome was to analysis the time taken to perform each method and the improvement in time with practice. Methods This was a study in a convenience study sample of 300 children between the age of 0 and 18 years at the Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa. Weight estimations were obtained using each of the four weight estimation systems on each child. These weight estimations were then compared against measured weight to determine bias, precision and accuracy of the estimation methods. Results The PAWPER XL and PAWPER XL-MAC performed the best with the estimated weight within 10% of actual weight (PW10) in 62.7% and 67.3% of cases followed by Mercy method (56.5%) and Broselow tape (43.9%). The use of MAC improved the accuracy of weight estimation especially in heavier and taller children. The median time taken to perform Broselow tape and PAWPER XL tape estimation in the first 10 children were 14.9 seconds and 10.9 seconds respectively. This time taken to acquire weight estimations only improved with the PAWPER XL-MAC and the Mercy method by up to 40.1% and 21.1% in each method respectively. Conclusion The PAWPER XL tape and PAWPER XL-MAC method were found to be the most accurate methods of weight estimation in this group of children and adolescents
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine (MMed.) in Emergency Medicine to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020