Doctors and nurses estimation of the weight of patients: A preventable source of systematic error.

BACKGROUND: Although accurate determination of body weight is important in the management of the poisoned patient, many patients have their weight estimated rather than formally measured. OBJECTIVE: To determine how good medical staff are at estimating patients*** body weights. METHODS: Medical staff were asked to estimate the weight of six patients on a poisons ward. Estimated and actual patient weights were statistically compared. RESULTS: Medical staff produced a large range of estimated weights for all patients. Patient weight was incorrectly estimated by greater than 10% in 61% of individual estimations. There was poor statistical correlation between actual and estimated weight. CONCLUSIONS: All patients administered medication based on body weight and those treated following an overdose of any substance should have formal body weight determined as part of their standard management.

Out of hospital cardiac arrest and associated injury.

Three patients are described who sustained injuries around the time of a collapse that led to out of hospital cardiac arrest. In this group of patients the importance of taking a complete medical history and recording the circumstances of the syncopal episode cannot be overemphasised. If cardiac output is successfully restored the possibility of occult traumatic injury must be considered in high risk patients.

Prolonged resuscitation in accidental hypothermia: use of mechanical cardio-pulmonary resuscitation and partial cardio-pulmonary bypass.

We report a case of profound accidental hypothermia with asystolic cardiac arrest which was reversed after 5.5 hours of mechanical cardio-pulmonary resuscitation. Rewarming was achieved by the use of partial cardio-pulmonary bypass.