Air Medical Journal: Estimation of Total Body Weight in Obese Patients

Abstract, from Science Direct:

Objective

Knowledge of accurate patient weight is vital to safe air medical transport and critical care. Patient weight is often unknown in emergency settings, and visual estimations have been shown to be inaccurate, especially in obese patients. We hypothesized that a simple formula based on anthropometric measurements could accurately predict patient weight for obese adult men and women.

Methods

Data from cross-sectional anthropometric measurements from the National Health and Nutrition Examination Survey (NHANES) III (1988–1994)—height, leg length, thigh circumference, and mid-arm circumference—were used to estimate patient weight among adult (18 years and older) men and nonpregnant women who weighed at least 100 kg (N = 1,471). Linear modeling was used to develop simple sex-specific linear models to estimate patient weight. Models were derived on a random 67% subset of the original sample and then validated against the remaining 33% to assess the model’s predictive capacity.

Results

The combination of arm circumference and height yielded the best model: Women: weight (WT) = −64.6 + 2.15 × arm circumference (ARM) + 0.54 × height (HT) (adjusted R2: 0.55); men: WT = −93.2 + 3.29 × ARM + 0.43 × HT (adjusted R2: 0.59). Approximately 90% of patient weights were accurately estimated within a 15% error tolerance.

Conclusion

We have derived and validated simple equations with easy-to-use tables to accurately predict total body weight of obese men and women using only height and arm circumference. These tables may assist air medical transport pilots and medical crews make decisions about which patients may be safely transported, how far they may be transported, how much fuel is required, and how many crewmembers and family members may accompany them.

ED EMR as a Recruiting Tool

From Hospitals and Health Networks:

When Alabama’s Cullman Regional Medical Center completed its nationwide search for a new physician group to take over its emergency room, its top choice presented a make-or-break demand: replace the department’s antiquated paper charts with a modern electronic medical record. For Neil Schamban, M.D., head of the group and now Cullman’s chairman of emergency medicine, an EMR is as essential as a stethoscope or blood pressure cuff. “If you want to deliver the best care, you can’t do that without a good EMR,” he says.

No stranger to technology in its other departments, Cullman realized it couldn’t attract the physician expertise it sought without the right IT portfolio. “Cullman, Ala., is a nice place, but it’s not the big city where some of these doctors are from,” says Jete Edmisson, chief financial and chief operating officer. “So we had to show we were willing to provide systems that are in harmony with what they’ve trained on. [New recruits] want to make sure that they’re not teleporting back to the ’70s.”

Once a source of physician angst and some famous walkouts, clinical information technologies are fast becoming the focus of recruiting efforts at many hospitals and their associated physician practices. Although some wired docs may be gadget addicts, most seek more practical benefits from technology. “Twenty years ago, location, location, location was the key to recruitment,” says Kurt Mosley, senior vice president of business development for Merritt Hawkins & Associates, a physician staffing agency. “Now it’s lifestyle, lifestyle, lifestyle.”

Digital Emergency Necklace Makes for Simple Reading, Updating

From Medgadget:

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Common medical emergency ID bracelets come in two forms: either a stainless steel plus engraving device, or a USB ID stick that paramedics need to plug into a laptop to read what’s on it. There’s a new device on the market that wants to revise the bracelet market. Emergency Data Link is essentially a small screen with a basic interface that displays easily accessible personal medical information that might be important to caretakers. It comes with software for the home PC that can be used to load allergies, medical conditions, and current medications taken to the device.

LifeBelt CPR Device Wins in Design Contest

From Medgadget:

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Developed by Thomas Lach of Deca-Medics Inc., Columbus, OH, LifeBelt overcomes a critical limitation of “hands-only” CPR: the average rescuer is only capable of producing effective chest compressions for about two minutes, far shorter than the typical eight to ten minute emergency response time. With LifeBelt, half as much force is needed, resulting in less fatigue and longer-duration compressions – increasing the likelihood of a successful resuscitation.

The compact, lightweight device is designed to attach quickly, enabling a rescuer to start CPR in 15 seconds or less. An intuitive readout warns if the compression depth is too deep or shallow, giving the rescuer confidence that he or she is pushing properly.

“Most cardiac arrests don’t occur in a hospital or controlled environment,” said Mr. Lach. “They happen at home or at work. This is an easy-to-use product for all of us.”

The Dubious Promise of Digital Medicine

From BusinessWeek:

In Washington, where partisan bickering over how to revive the economy flares on several fronts, sweet consensus reigns on health-tech spending. Congressional Republicans sound just as enthusiastic as the White House. Encouraged by former House Speaker Newt Gingrich, now an influential industry consultant, lawmakers cheer electronic records as a business-based remedy for much that ails medical care.

That rare agreement, however, is obscuring the checkered history of computerized medical files and drowning out legitimate questions about their effectiveness. Cerner, based in Kansas City, Mo., and other industry leaders are pushing expensive systems with serious shortcomings, some doctors say. The high cost and questionable quality of products currently on the market are important reasons why barely 1 in 50 hospitals has a comprehensive electronic records system, according to a study published in March in the New England Journal of Medicine. Only 17% of physicians use any type of electronic records.

Hospitals and medical practices that plugged in early have experienced pricey setbacks and serious computer errors.

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