In a child, calculate drug doses and fluid volumes from an actual measured weight, not an age-based estimate, and record that weight prominently so the next clinician uses the same figure. For the unwell child who cannot be weighed, use a length-based estimation tool rather than guessing.
Double-check high-risk calculations (resuscitation fluids, insulin, opioids, anticonvulsants) and the units, since a tenfold error in a small child is easy to make and hard to undo. Re-check the weight at each admission, because children change quickly and a stale weight drives a wrong dose.
- Prescribe drugs and fluids from a measured weight, not an age estimate.
- Use a length-based tool when an unwell child cannot be weighed.
- Double-check high-risk calculations and units for tenfold errors.
- Record the weight clearly and re-check it at each admission.
Why it matters
Weight-based dosing errors are among the commonest and most dangerous avoidable harms in children.
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