Paediatric analgesia in the emergency department, are we getting it right?

Colin Donald, Russell Duncan, Lorraine Blair, Shobhan Thakore, Michael Clark

    Research output: Contribution to journalArticle

    9 Citations (Scopus)

    Abstract

    Objectives: To measure the dose discrepancy in prescribing simple paediatric analgesia, in the emergency department, by comparing age and actual weight-based dosing. To establish the accuracy of the weight-estimation formula for children [weight kg=2 (age years+4)].
    Methods: A prospective survey conducted in the emergency departments of a UK teaching hospital and district general hospital. Two hundred and forty-seven children were prescribed simple analgesia in the form of paracetamol and ibuprofen or both. The dose prescribed was based on age. All children were weighed and a maximum dose based on the child's weight was calculated. The individual child's weight was also compared with the weight calculated using the estimation formula.
    Results: A total of 247 patients were included. Two hundred and thirty-three patients were prescribed paracetamol. Fifteen patients were prescribed ibuprofen. The paracetamol group was administered a mean dose that was 67% (P<0.001) of the optimal dose that was based on weight. Ibuprofen dosage was 51% (P<0.001) of optimal dose. The weight-estimation formula underestimated weight by 16% (P<0.001).
    Conclusions: Prescribing analgesia by age often results in significant underdosing in the paediatric population. Predicting a child's weight using the calculation may result in underdosing.
    Original languageEnglish
    Pages (from-to)157-9
    Number of pages3
    JournalEuropean Journal of Emergency Medicine
    Volume14
    Issue number3
    DOIs
    Publication statusPublished - Jun 2007

    Keywords

    • Acetaminophen
    • Age Factors
    • Analgesia
    • Analgesics, Non-Narcotic
    • Body Weight
    • Child
    • Child, Preschool
    • Emergency Service, Hospital
    • Female
    • Health Care Surveys
    • Humans
    • Ibuprofen
    • Infant
    • Infant, Newborn
    • Male
    • Medical Audit
    • Pediatrics
    • Prospective Studies
    • Scotland

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