One of the most important ways to prevent
a catastrophic drug-dos-ing error in the emergency department (ED) comes down
to a simple safety precaution: Weigh all
patients in kilograms only.
That’s the recommendation in an updated AAP-endorsed statement from the
Emergency Nurses Association (ENA).
The Academy also endorsed the ENA’s
2012 statement calling for use of kilograms in the ED.
Weighing All Patients in Kilograms is
available at http://bit.ly/2uqdBc8 and
is announced in the October issue of
Pediatrics. The endorsement aligns with
guidance from the Academy and other
organizations (see resources).
More than 40% of fatal medication
errors can be traced to dosing errors,
according to the position statement.
Children are especially vulnerable.
When weight is recorded incorrectly in
any pediatric setting, it can trigger a host
of medical errors. Errors that originate
in the ED, for example, can follow the
patient throughout a hospital visit.
The position statement includes the
following recommendations aimed at
• Patient weights should be measured,
recorded and displayed in a promi-
nent place in the medical record in
• Multiple types of scales should be
available in the emergency setting,
all configured to record weights in
• For patients under age 18 years,
clinical decision support features
should be used to compare weight
with expected weight (such as based
on growth charts) and provide
real-time alerts whether under-dose
or over-dose is suspected.
• Electronic medical records (EMRs)
should allow for weight entries only
in kilograms. Institutions should
consider integrating digital scales
with the EMR to eliminate or reduce
the need for data entry.
• The patient’s weight in kilograms
should be included on all prescriptions and in all inter- and intra-dis-ciplinary patient hand-offs.
• Joint policy statement Guidelines for
Care of Children in the Emergency
• AAP News article “Weigh in kilograms
to cut dosing errors,” http://www.