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ENA: Weigh pediatric patients only in kilograms


The Emergency Nurses Association has developed a position statement supporting the use of scales that read in kilograms for the weighing of pediatric patients.

The American College of Emergency Physicians, the American Academy of Pediatrics and the Institute for Safe Medicine Practices endorsed the position statement, which is an effort to reduce medication dosing errors that may stem from confusion between pounds and kilograms.

Pediatric medication doses are weight-based, unlike the standard dosing units used for adult patients, and the recommended dosages are given in kilograms. Potential for confusion arises when a scale reading is in pounds, the ENA noted.

The position statement, “Weighing Pediatric Patients in Kilograms,” recommends the following practices:

• Scales used to weigh pediatric patients should be configured to record weights only in kilograms.

• Pediatric weights should be recorded in a prominent place on the medical record.

• Electronic medical records should be standardized to allow only kilograms for pediatric weight entries.

• The pediatric patient’s actual weight should be considered part of the mandatory nursing assessment unless the patient requires resuscitation or emergent stabilization.

• For the pediatric patient who requires resuscitation or emergent stabilization, a standard method of estimating weight in kilograms should be used (such as a length-based system).

• The pediatric patient’s weight in kilograms should be included in any inter- or intra-disciplinary patient handoff.

“Medication errors are always serious, but in the emergency department, and with infants and children, they can have particularly serious consequences,” ENA President Gail Lenehan, RN, EdD, MSN, FAEN, FAAN, said in a news release.

“Determining the correct dose of a pediatric medication typically requires multiple calculations, and is challenging enough. The need to additionally convert pounds adds to the confusion, which can result in serious, even fatal medication errors.

“This is a serious, even deadly problem, with a very easy solution: weighing pediatric patients only in kilos.”

A PDF of the statement is available at


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