Agreement Between Paramedic-Estimated Weights and Subsequent Hospital Measurements in Adults with Out-of-Hospital Cardiac Arrest

Abstract

Purpose: To assess the accuracy of paramedic estimates of adult body weights in cardiac arrest cases. Methods: This study was a retrospective data analysis of a 15month, multicenter study involving non-traumatic, out-of-hospital, cardiac arrest patients. Paramedic estimates of body weights were compared to weights measured in the hospital. Patients were included in the analysis only if both a paramedic weight and a measured in-hospital weight were recorded. The study population included 133 adults with return of spontaneous circulation who subsequently were admitted to the hospital. A Pearson correlation analysis was used to compare paramedic-estimated weights and measured weights. Results: Among the 133 study patients, the correlation coefficient for paramedic estimates and the actual measured weight was 0.865. Paramedic estimates of weight were within 10% of the measured weights in 74% of the patients, and within 20% of measured weights in 93% of the patients. Subgroup analysis by gender and weight category (<150 pounds and greater than 150 pounds) demonstrated no clinically significant differences in the ability of paramedics to estimate body weight. Conclusion: Paramedic weight estimates correlated well with measured weights. Therapeutic decisions utilizing paramedicestimated weights should not result in significant dosing errors of pharmacologic agents used in adult out-of-hospital cardiac arrest.

Canadian Paramedic Experience with Intramuscular Ketamine for Extreme Agitation: A Quality Improvement Initiative

“…Our paramedics also recorded an estimated weight on only 60% of patients which is comparable to a study by Hollis where paramedics recorded weights on 26/38 patients (25). Research on paramedic weight estimation is mixed (33)(34)(35) and we are unable to confirm whether the ACPs estimated weights with any degree of accuracy, something that would affect the dose of ketamine given, and would require further study.…”

How accurate is weight estimation in the emergency department?

“…Our results confirm that patients are generally accurate in estimating their true weight and that health care workers have only moderate accuracy. The large sample size and ethnic diversity of this sample taken together with previously published data 1–3 suggest the errors in weight estimation by health care workers are common.…”

“…They reported that 29% of physicians’ estimates, 40% of nurses’ estimates and 16% of parents’ estimates differed from the actual weight by more than 15%. A similar study 3 comparing weight estimates by paramedics and actual weights for 133 patients who had suffered a cardiac arrest, found that paramedic estimates of weight were within 10% of the measured weights in 74% of the patients, and within 20% of measured weights in 93% of the patients.…”

Who Should Be Estimating a Patient's Weight in the Emergency Department?

“…The majority of prior studies on this topic were related to the out-of-hospital setting, where paramedics assessed how well they estimate patients' weights in order to administer Advanced Cardiac Life Support (ACLS) weight-based medications. 1 A small Canadian ED study showed that the physicians' and nurses' estimates of adult patients were unreliable. 3 There is no routine practice of how ED personnel obtain the patient's weight value for calculations of weight-based medications.…”

“…Inaccurate estimates of weight might result in the administration of either subtherapeutic or, in other cases, toxic doses of pharmacologic agents. 1 Few studies have evaluated the accuracy of weight estimations. [1][2][3] The purpose of this study was to assess the accuracy of estimations of patients' weight by the patients themselves, physicians, and nurses in the ED by comparing the estimates with the actual measured body weights.…”