Emergency situations involving the transfer of children are infrequent for many Wisconsin Emergency Medical Services (EMS) agencies, but they are often very critical situations when they do occur. Added stress comes from medication administration, as all pediatric medications are weight-based and require weight-based dosing calculations, which can be difficult in the highly charged clinical situations.
While accurate weight estimates are critical in determining medication dosages for pediatric patients, estimating a child’s weight can be very challenging. Depending on the child’s age and status, they may be unable to communicate their weight to providers. EMS personnel must then rely on family member reports, visual estimates, or references based on age or height. From there, EMS personnel convert a weight measured in pounds to kilograms, then calculate a weight-appropriate dose, which can be taxing. Due to the unpredictability of the prehospital setting, these calculations are done quickly in highly stressful and chaotic situations. This process also takes critical time away from managing the patient, and can lead to medication dosing errors.
Cars Curing Kids funding
Wisconsin Emergency Medical Services for Children (WI EMSC) has launched a quality improvement project focused on improving weight estimate accuracy and increasing the proportion of pediatric EMS encounters with documentation of estimated weight in kilograms. Thanks to a generous funding opportunity from Cars Curing Kids, part of this initiative includes providing all 1,970 ambulances and emergency medical responder (EMR) groups in the state with a retractable, Broselow-compatible weight measuring tape and a corresponding reference card. These resources will help EMS personnel increase weight documentation and rapidly assess correct medication dosing and equipment sizes for their pediatric patients.
“Medication dosing accuracy is paramount to safety when treating children,” says Dr. Michael Kim, associate professor in the Department of Emergency Medicine and Pediatrics at the University of Wisconsin and WI EMSC Advisory Committee Co-Chair. “The first step in reducing medication dosing errors is having accurate weight estimates. Using these weight measuring tapes, EMS providers will be able to obtain these estimates right away and deliver the appropriate care.”
Over 50,000 pediatric ambulance runs occur in Wisconsin each year. Providing all ambulances statewide with these resources will dramatically increase the ease, speed, and degree of accuracy with which EMS personnel are able to estimate a child’s weight and help determine proper medication dosages and equipment sizes.
This project will especially improve care in rural Wisconsin, where pediatric transports are rare and transport times are the longest. The likelihood that EMS providers must estimate a pediatric patient’s weight to administer medication or select the appropriate medical equipment size is greater the longer that the patient spends in an ambulance en route to a hospital.
“In rural areas, the frequency of pediatric encounters can be very low,” says Kim. “And with longer transport times to the nearest hospital, equipping every ambulance with a weight measuring tape enhances the ability to quickly obtain weights as needed. Children arrive at facilities having received better care along the way, which helps hospital personnel jump in and continue treatment, rather than having to start from the beginning.”
The focus on weight estimate accuracy and availability of weight measuring tapes for EMS personnel statewide represents a major shift in enhancing safety for pediatric patient care through medication dosing and equipment sizes, thus ensuring children receive higher-quality care no matter where they live in Wisconsin.
More from Dr. Michael Kim
Watch this quick video as Michael Kim, MD, discusses the “heavy” issue of why obtaining weight estimates for all pediatric patients is so critical, especially in the prehospital setting.
Order your Broselow-compatible tape
To obtain these Broselow-compatible weight measuring tapes at your EMS agency, fill out this request form.