scholarly journals Brief communication (Original). The accuracy of the Broselow tape in the weight estimation of Thai children

2014 ◽  
Vol 8 (6) ◽  
pp. 799-807 ◽  
Author(s):  
Piyawan Chiengkriwate ◽  
Rattaporn Donnapee ◽  
Alan Geater
Keyword(s):  
Medical Treatment ◽  
Demographic Data ◽  
Weight Estimation ◽  
Inclusion Criteria ◽  
Color Code ◽  
Drug Dosing ◽  
Actual Weight ◽  
Measured Weight ◽  
The Mean ◽  
Child’S Weight

Abstract Background: The effectiveness of medical treatment depends on proper drug dosing. The most accurate measurement of a child’s weight is by weighing the child on a scale, and can be done for stable children. However, an emergency, or other conditions may preclude normal weighing. The child’s weight must then be estimated quickly for treatment including drug dosages, equipment sizes, ventilator volume settings, and cardioversiondefibrillation. Objectives: To assess the accuracy of the Broselow tape in the weight estimation of Thai children. Methods: Retrospective analysis reviewing the hospital-based data of 4746 Thai children aged less than 15 years. Demographic data, measured weight (MW), and height were collected. The subjects were divided into nine color-coded groups according to the Broselow tape color range and the actual weight plotted according to their groups. Comparison between Broselow tape-predicted weight (TW), height and MW was explored. Results: A total of 3869 children met the inclusion criteria, of whom 2121 (54.8%) were male. The overall agreement between actual weight and predicted weight was 62.1% (range 36.4-90.5 depending on color-code). The mean difference between TW and MW was -3.56% (95% CI -3.964 to -3.150) with SD 12.91%, P < 0.001. TW was within a 10% error for 58% of children. Conclusions: The accuracy of the Broselow tape in the weight estimation of Thai children decreases with increasing height. The Broselow tape underestimates Thai children’s weight.

Parental Perceptions and Behaviors Regarding Child Weight Status among Toddlers Born Preterm

2019 ◽  
Vol 37 (05) ◽  
pp. 525-533
Author(s):  
Jessica Londeree Saleska ◽  
Kelly Sheppard ◽  
Abigail Norris Turner ◽  
Kelly M. Boone ◽  
Sarah A. Keim
Keyword(s):  
Weight Status ◽  
Controlled Trial ◽  
Parental Perceptions ◽  
Normal Weight ◽  
Overweight Children ◽  
Weight Estimation ◽  
Child Feeding ◽  
Actual Weight ◽  
Child Weight ◽  
Child’S Weight

Abstract Objective Childhood obesity is a significant determinant of adult obesity. Among children born preterm, rapid “catch-up growth” in infancy increases the risk of later obesity. Parental perceptions of their child's weight status may compound the child's biologically heightened risk of obesity. Study Design We performed a secondary analysis of data on parental perceptions of child weight status from a randomized controlled trial (2012–2017, n = 331 toddlers born preterm). We used the Child Feeding Questionnaire (CFQ) to measure parental child feeding behaviors and beliefs. We calculated the prevalence of incorrect weight estimation, and used t-tests and chi-square tests to compare sample characteristics by correct versus incorrect weight estimation. We calculated odds ratios (ORs) for factors associated with parental underestimation of child weight status. Results Most (90%) children were of normal weight, whereas 3% were underweight and 7% were overweight. A majority (75%) of parents correctly estimated their child's weight status. Incorrect weight estimation was only associated with child's actual weight. Parents of overweight children were more likely to underestimate their child's weight status than parents of normal weight children (OR: 2.23, 95% confidence interval: 2.00–2.49). Mean CFQ scores differed by the child's actual weight status but not by the child's estimated weight status. Conclusion Among these toddlers born preterm, significantly higher proportions of parents with underweight and overweight children incorrectly estimated their child's weight status relative to parents of normal weight children. Our findings suggest that weight underestimation could be a problem in this population, although it was not associated with changes in feeding practices.

Guess the weight: the accuracy of estimated weight for surgical admissions – a comparison study

2018 ◽  
Vol 64 (2) ◽  
pp. 56-61
Author(s):  
Rachel AB Thomas ◽  
Julie-Ann Empey ◽  
Subodh Seth ◽  
Joseph Crozier
Keyword(s):  
Healthcare Workers ◽  
Surgical Patients ◽  
Comparison Study ◽  
Weight Estimation ◽  
Support Worker ◽  
Emergency Admissions ◽  
Drug Dosing ◽  
Actual Weight ◽  
Emergency Department Staff ◽  
Department Staff

Background and aims An accurate body weight is vital for safe dosing of many drugs. Weight is often unavailable for emergency admissions and an estimation is used. Emergency Department staff are poor at estimating patient weight, but no data existed for surgical admissions. This study assesses the reliability of weight estimation by patients and healthcare workers. Methods and results All emergency surgical patients admitted during one week were approached. If consented, four healthcare workers (consultant, foundation doctor, nurse, support worker) independently estimated their weight. The patients then gave their estimate. Actual weight was measured and data analysed. Seventy-two consecutive surgical admissions were included, aged 16–95 and 52% male. Healthcare workers correctly (within ±10% margin) estimated the weight for only 57% of patients. Further statistical analysis confirmed that staff are inaccurate estimators and patients are better at estimating their own weight (p < 0.006). Conclusions Staff are poor at estimating weight and the study was unable to show statistical superiority of any professional group when guessing weights. There was also a tendency for staff to increasingly under-estimate as weight increases. Patients are the most accurate estimators, but self-reporting is still too unreliable for drug dosing and should stop.

scholarly journals Estimation of Fetal Birth Weight Using Ultra Sonographic Parameters

1970 ◽  
Vol 39 (135) ◽  
pp. 284-286
Author(s):  
Kaveeta Dawaka ◽  
G C Das
Keyword(s):  
Birth Weight ◽  
Fetal Weight ◽  
Weight Estimation ◽  
Term Pregnancy ◽  
Femur Length ◽  
Actual Weight ◽  
Medical College ◽  
Biparietal Diameter ◽  
Fetal Birth Weight ◽  
The Mean

One hundred antenatal patients were studied at term pregnancy at Gauhati Medical College, Guwahati, andfetal birth weight estimation was done in utero Ultrasono-graphically. The parameters measured wereAbdominal Circumference (AC), Biparietal diameter (BPD) and Femur Length (FL), Fetal weightprediction was done with Shepards formula using AC and BPD as well as Hadlocks formula using FL andAC. The scan delivery interval was maintained at 72 hours or less. Results of both formulae were comparedwith the actual fetal birthweight taken within 15 minutes of delivery. With Shepards formula, the predictedfetal weight was within 100 gm of the actual fetal weight in 71% cases, within 150gm in 86% cases, within200 gms in 93% cases and within 250 gms in 98%. With Hadlocks formula, the predicted birthweight waswithin 100 gms of the actual fetal weight in 72% cases, within 150 gms in 83%, within 200 gms in 92%cases and within 300 gms in 98%. The mean percent error calculated as Error % = Predicted weight - actualweight divided by actual weight x 100 was 2.9% with Shepards formula and 3% with Hadlocks. These datathus support a significant correlation between ultrasonographic estimation and actual fetal birth weight.Key Words: Fetal birth weight, AC, BPD, FL

scholarly journals Scoliosis may increase the risk of recurrence of lumbar disc herniation after microdiscectomy

2016 ◽  
Vol 24 (4) ◽  
pp. 586-591 ◽  
Author(s):  
Hsuan-Kan Chang ◽  
Huang-Chou Chang ◽  
Jau-Ching Wu ◽  
Tsung-Hsi Tu ◽  
Li-Yu Fay ◽  
...  
Keyword(s):  
Young Adults ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Demographic Data ◽  
Exclusion Criterion ◽  
Inclusion Criteria ◽  
Risk Of Recurrence ◽  
The Mean

OBJECT The aim of this paper was to investigate the risk of recurrence of lumbar disc herniation (LDH) in patients with scoliosis who underwent microdiscectomy. METHODS A series of consecutive patients who underwent microdiscectomy for LDH was retrospectively reviewed. The inclusion criteria were young adults younger than 40 years who received microdiscectomy for symptomatic 1-level LDH. An exclusion criterion was any previous spinal surgery, including fusion or correction of scoliosis. The patients were divided into 2 groups: those with scoliosis and those without scoliosis. The demographic data in the 2 groups were similar. All medical records and clinical and radiological evaluations were reviewed. RESULTS A total of 58 patients who underwent 1-level microdiscectomy for LDH were analyzed. During the mean follow-up of 24.6 months, 6 patients (10.3%) experienced a recurrence of LDH with variable symptoms. The recurrence rate was significantly higher among the scoliosis group than the nonscoliosis group (33.3% vs 2.3%, p = 0.001). Furthermore, the recurrence-free interval in the scoliosis group was short. CONCLUSIONS Young adults (< 40 years) with uncorrected scoliosis are at higher risk of recurrent LDH after microdiscectomy.

scholarly journals Ten Years of Alcohol Intoxication in Adolescents and Treatment in Paediatric Departments in Dutch Hospitals

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Longitudinal Study ◽  
Medical Treatment ◽  
Surveillance System ◽  
Alcohol Intoxication ◽  
Health Concern ◽  
First Year ◽  
Longitudinal Analyses ◽  
Inclusion Criteria ◽  
Patient Interview ◽  
The Mean

Aim: Alcohol intoxication in children and adolescents is a severe health concern in current paediatrics. In this longitudinal study, we monitored the intake and treatment of 5,323 adolescents in the Departments of Paediatrics in Dutch hospitals from 2007 to 2016. Methods: From 2007 to 2016, we collected data on all adolescents (inclusion criteria: age younger than 18 and a positive BAC) treated by a papediatrician in a hospital. Within the Dutch Pediatric Surveillance System (NSCK), pediatricians report adolescents and complete a questionnaire, making use of a patient interview. Results: In total, 5,323 adolescents were treated, mainly (4,674; 88%) for severe alcohol intoxication; the mean age was 15.4 years, and 52% were boys. The average BAC level increased during the study period (1.82 in 2007 to 2.01 in 2016), and the average reduced consciousness time lasted from 2.24 hours in 2007 to 3.12 hours in 2016. The attitudes of the parents changed over the years: in 2011 (first year of registration for this measure), 24% of the parents did not give permission to their under-aged son or daughter to drink alcohol; however, in 2016, this number had increased to 58%. Conclusion: Alcohol intoxication treatment in adolescents remains an important issue. This dataset enables us to conduct longitudinal analyses on the characteristics of alcohol intoxication in adolescents, the medical treatment, and the events leading up to the intoxication.

The outcome of transscleral cyclophotocoagulation for the management of acute angle closure

2017 ◽  
Vol 28 (2) ◽  
pp. 188-192 ◽  
Author(s):  
Patrick J. Chiam ◽  
Velota C.T. Sung
Keyword(s):  
Medical Treatment ◽  
Case Series ◽  
Acute Angle ◽  
Angle Closure ◽  
Inclusion Criteria ◽  
Laser Peripheral Iridotomy ◽  
Lens Extraction ◽  
Acute Angle Closure ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean

Purpose: To investigate the outcome of transscleral cyclophotocoagulation (TCP) in the treatment of acute angle closure (AAC) refractory to medical treatment. Methods: This is a retrospective interventional case series. The inclusion criteria include patients diagnosed with AAC who had TCP. Pre-TCP and post-TCP intraocular pressure (IOP), visual acuity, and AAC treatment were analyzed. The complications and the results of subsequent treatments including lens extraction if performed were also assessed. Results: Thirteen eyes (13 patients) met the study criteria. The median time to TCP from presentation was 5 days (range 3-30 days). The mean presenting IOP was 56 ± 6 mm Hg (range 48-70 mm Hg) and the medically treated mean IOP before TCP was 40 ± 5 mm Hg (range 34-52 mm Hg). All patients (100%) responded to TCP. The mean post-TCP IOP at day 1 and months 1, 3, 6, 12, and 24 were 19, 23, 19, 19, 18, and 17 mm Hg. There was 1 case of hyphema post-TCP. Lens extraction ± goniosynechialysis was performed in 10 patients (77%) from 1 month post-TCP onwards. The mean IOP prior to lens extraction was 26 mm Hg (range 19-32 mm Hg). The mean IOP 3 months after lens extraction was 15 mm Hg (range 8-19 mm Hg). The mean number of topical IOP-lowering medications 12 months post-TCP was 1.1. Conclusions: Transscleral cyclophotocoagulation is effective and safe in reducing IOP in patients with AAC refractory to medical and laser peripheral iridotomy treatments. We advocate that TCP should be considered early in the management of AAC refractory to medical treatment to avoid irreversible optic neuropathy.

Abstract W P339: Time Is Brain: A Tale of Unintended Consequences

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Carolyn Santora ◽  
Dan Cammarata ◽  
Eileen Conlon ◽  
Eileen Dowdy ◽  
Kathleen Ferrara ◽  
...  
Keyword(s):  
Ct Scan ◽  
Negative Impact ◽  
Stroke Care ◽  
Unintended Consequences ◽  
Successful Implementation ◽  
Weight Estimation ◽  
Deep Dive ◽  
Time To Treatment ◽  
Actual Weight ◽  
Measured Weight

Background: There is a narrow therapeutic range for thrombolysis in stroke. “Time is Brain” emphasizes the concept that nervous tissue is rapidly lost as stroke progresses. Research suggests 1.9 million neurons are lost each minute of untreated stroke. Urgency to treat led to the practice of estimating weight on arrival. Unfortunately, expediency of weight estimation can result in over or under dosing. After a devastating adverse outcome related to misdose of tPA based on estimated weight, SBUH implemented a protocol that ensures actual weight measurement before administration of thrombolytics without delaying time to treatment. Process: Our state accredited stroke program is recognized with the AHA Gold Plus Award. Door to needle time for tPA was below 60 minutes. Estimated weight dosing was standard as supported in the NINDS t-PA stroke study as not having negative impact on outcome. At SBUH in 2013 a patient had estimated weight entered of 90 kg. A CT Scan was performed within 9 minutes and tPA dose of 81 mg given within 57 minutes. Stroke symptoms resolved. This was an apparent successful implementation of protocol. Five hours later patient had mental status changes and emergent CT Scan revealed catastrophic intracranial hemorrhage. The patient died 13 hours later. It was believed that this patient was among the 6.9% that experience this known complication of tPA. A review of the chart revealed that the measured weight entered on the stroke unit did not match the estimated weight; the calculated dose was 40% more than should have been. The error was disclosed to the family and a deep dive and RCAs were completed. The error was reported to TJC and the state DOH. Outcomes: EPR changes including soft stops, changes in the weight fields, and process changes including a tPA time out and equipment use to ensure measured weights were implemented. The new processes did not compromise door to needle time. Average Door to needle time pre implementation was 66.88 minutes. Post implementation time is 63.1. Conclusions: The expediency of weight estimation can result in over or under dosing of tPA. At SBUH, we implemented a process that ensures actual weights before administration of thrombolytics but does not delay time to treatment. This is a safer and more effective process for stroke care.

Weight perception and symptoms of depression in rural Australian adolescents

2021 ◽  
pp. 103985622110092
Author(s):  
Samuel Skidmore ◽  
Catherine Hawke ◽  
Georgina Luscombe ◽  
Philip Hazell ◽  
Katharine Steinbeck
Keyword(s):  
Demographic Data ◽  
Weight Perception ◽  
World Health ◽  
Actual Weight ◽  
Symptoms Of Depression ◽  
Measured Weight ◽  
Illness Prevention ◽  
Perceived Weight ◽  
And Gender ◽  
Rural Adolescent

Objective To investigate associations between measured and perceived weight, and symptoms of depression in rural Australian adolescents. Method: At baseline a prospective rural adolescent cohort study collected demographic data, measured weight and height, weight self-perception, and presence of depression (Short Mood and Feelings Questionnaire). Using World Health Organisation’s (WHO) age and gender body mass index (BMI) standardisations, participants were classified into four perceptual groups: PG1 healthy/perceived healthy; PG2 overweight/perceived overweight; PG3 healthy/perceived overweight; and PG4 overweight/perceived healthy. Logistic regression analyses explored relationships between these groups and symptoms of depression. Results: Data on adolescents ( n = 339) aged 9–14. PG1 contained 63% of participants, PG2 18%, PG3 4% and PG4 14%. Across the cohort, 32% were overweight and 13% had symptoms of depression. PG2 (overweight/perceived overweight) were more likely to experience symptoms of depression than PG1 (healthy/perceived healthy; Adjusted Odds Ratio [AOR] 3.1, 95% CI 1.5–6.7). Females in PG3 (healthy/perceived overweight) were more likely to experience symptoms of depression (38%) than males (14%) and females in PG1 (10%, AOR 5.4, 95% CI 1.1–28.2). Conclusions: Results suggest that perceptions of being overweight may be a greater predictor for symptoms of depression than actual weight. This has public health implications for youth mental health screening and illness prevention.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

Effect of Surgical Versus Pharmacological Decompression of Ludwig’s Angina on Airway Compromise among Nigerian Patients

2020 ◽  
Author(s):  
Ekaniyere EB
Keyword(s):  
Length Of Hospital Stay ◽  
Surgical Decompression ◽  
Airway Compromise ◽  
Inclusion Criteria ◽  
Hospital Stays ◽  
Ludwig’S Angina ◽  
The Mean ◽  
The University ◽  
Ludwig's Angina ◽  
Gender Type

Background: Even though the decompression of the cellulitis phase of Ludwig’s angina (LA) by surgical or pharmacological approach is well documented, it is unclear which approach is more effective. Objective: We aim to compare the outcome of treatment between surgical versus pharmacological decompression in patients with LA. Subjects and Methods: A retrospective cohort study was designed. Data were collected from the case notes of patients that met the inclusion criteria from 2004 to 2018 at the University of Benin Teaching Hospital, Nigeria.The data were age, gender, type of decompression approach, length of hospital stay (LOS) and airway compromise. Result: A total of 62 patients comprising 37(59.7%) surgical decompression group and 25(40.3%) pharmacological decompression group were studied. Thirty-six (58.1%) males and 26 (41.9%) females were studied. Their mean age and standard deviation were 40.6 years and 11.9 years respectively. The mean length of hospital stays between the pharmacological and surgical decompression groups were 8.05 days and 13.8 days respectively. The incidence of airway compromise in the surgical decompression group was 19.9% lower than that of the pharmacological decompression group (P=0.47), which was not significant. The type of decompression approach also failed to influence the incidence of airway compromise (P = 0.41). Conclusion: The use of surgical versus pharmacological decompression does not significantly alter the incidence of airway compromise in the management of LA. The Patients that had surgical decompression had a shorter stay in the hospital as compared to those who had pharmacological decompression. This was not statistically significant.

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