We love this website - enter your kiddo's age and weight and this site will direct you to appropriate seats, buying tips and even alert you when it's time to update seating status.
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Emergency Medical Services for Children
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NEW HAMPSHIRE
Dosing Safely
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Pediatric dosing can be intimidating. Don't let this prevent you from appropriately treating your pediatric patients! Remember that pediatric dosing is weight-based, using the child's weight in kilograms. Here are some tools to help you determine a child's weight in kilograms to improve your dosing accuracy.
Policy statement
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Sites should define age range for pediatric population
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Weight should be recorded at every ED encounter
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Ensure that either an actual weight (i.e., gurney weight) or weight based on patient length (i.e., using the length-based tape) is used for all resuscitations
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Frequency that ED pharmacists attend a pediatric resuscitation and assist with medication administration
Infrastructure changes
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Utilize a scale that only weighs pediatric patients in kilograms or can be locked in kilograms
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Utilize gurney weights on all patients for whom staff are unable to get a scale weight
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Utilize a length-based tape and ensure that it is available
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Utilize a single formulation for each medication
Electronic medical record (EMR) optimization
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EMR alerts care team when weight is not recorded in correct unit
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EMR alerts care team that weight does not coincide with patient’s height and age
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For resuscitation, weight is a required entry in the patient’s medical record
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Consider using standard weight nomograms (e.g., World Health Organization)
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EMR automatically calculates medication dosing based on weight recorded in kilograms in medical record
Education
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Integrate ED pharmacists into the healthcare team
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Develop training/educational content for care team
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Learning objectives should include: proper use of length-based tape, necessity of weight measurement required in cases of resuscitation, safety issues (e.g., number of reported medication errors), methods of measuring weight, nomograms, family engagement, your site’s policy; PRQC change strategies)
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Identify training modality (e.g., online, in-person, staff-meetings, peer to peer, EMR alerts)
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Identify strategies to increase families’ engagement
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Weight should not be estimated but measured
Knowledge reinforcement for care team
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Posters in triage and clinical care areas
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Direct feedback to care team following chart audits
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Develop script for use by triage nurse
Patient & Family Engagement
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Offer families a preprinted chart with their child’s measured weight in kilograms and corresponding pounds. Template here.
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Disseminate weight infographic/conversion chart to empower caregiver engagement. Template here.
Prescribing Patterns (deep dive for outcome measure)
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Manually track the number of incidences when an incorrect dose of a medication was ordered for a patient based on their weight
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Track high risk conditions with common errors in prescribing and administration medication administration (deep dive for outcome measure)
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Integrate a tool that nurses can reference to ensure that medication dosing is appropriate (use standard nomograms as reference)
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Integrate a nurse-to-nurse cross-check to ensure that medication dosing is appropriate. If site has bandwidth to accommodate this effort, consider cross-check for high-risk patients/medications or cross-checks during off-peak hours in the ED.
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Work with pharmacy team to develop notification system in the event that a prescribed medication does not coincide with standard practice
Additional content
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Collated content and resources
EIIC PRQC Weight in Kg Intervention Bundle (2016)
EIIC PRQC Weight in Kg Intervention Bundle (2023, in process)
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Infographic
Weight in kg only infographic
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Videos
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Publications, Position Statements
NEMSQA Pediatrics-03b Measure Package