Written by: Ben Mulick
Weighing children in kilograms in the emergency department (ED) is critical, something Dr. Lorin Browne, associate professor of pediatrics and emergency medicine at Children’s Wisconsin and associate medical director at Milwaukee County Emergency Medical Services, cannot stress enough. “By doing so, you will standardize practice of your pediatric patients, and you will reduce the potential for errors in your medication dosing in those patients.”
Unfortunately, mistakes can occur in high pressure ED situations. Children are at an increased risk for dosing errors and are more vulnerable to the effects of those errors when they occur. Often, incorrect dosages are attributable to incorrect weight estimates recorded in the ED. “The international standard for using weights in medicine is to use weights in kilograms. Unfortunately, weights in pounds are about two times the weights in kilograms,” says Dr. Browne. “So, if you confuse the two, it can lead to medical mistakes and medical errors.”
In order to get accurate measurements more consistently, the American Academy of Pediatrics (AAP) recommends that patient weights be measured, recorded, communicated and documented using kilograms only. Standardizing all weights in kilograms helps to reduce errors caused by converting measurements from one system to another and helps ED staff treat pediatric patients more safely and effectively.
EDs can take simple steps to make the change from weighing children in pounds to kilograms. “You can leverage your scales. Many scales have an option that you can set it to default to only give you the weight in kilograms. If this is your practice in your ED, you will never accidentally obtain a weight in pounds. The other thing you can do is to leverage your electronic medical record. You should be able to customize your electronic medical record to allow you to enter weights only in kilograms, and then to have weights only in displayed in kilograms,” notes Dr. Browne.
“This is a behavioral switch. This is a difference for many practitioners and it can be difficult at first, and uncomfortable, to make this change. It may take time getting used to this for you and your staff at first, but for Wisconsin pediatric patients, it will be more than worth the weight.”
Watch the full video here.