Contrast and radiation dose calculations in children run off a number typed into a request form, and that number is frequently copied from a previous episode. A six-month-old gains weight faster than any workflow updates, and a teenager's recorded weight can be two years old.
So weigh the child in the department, on the day, before the contrast is drawn up. It takes under a minute and it is the only input to the dose that nobody else has verified. Where a child cannot be weighed, record what estimate was used and how it was derived, so the next person does not inherit a guess as a measurement.
The same discipline applies to the height needed for lean body weight or body surface area calculations. An unrecorded height turns an individualised protocol back into a weight-band one, which is the thing the protocol was designed to replace.
- Weigh the child in the department on the day, not from the request form
- Record height too where the protocol needs lean body weight or body surface area
- Document the source when a weight must be estimated, and label it as an estimate
- Recheck the weight for any repeat study more than a few weeks later in infants
- Confirm the concentration of the contrast agent as well as the volume - both determine the iodine dose
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