A Validation Study of the PAWPER (Pediatric Advanced Weight Prediction in the Emergency Room) Tape--A New Weight Estimation Tool

J Pediatr. 2015 Jul;167(1):173-7.e1. doi: 10.1016/j.jpeds.2015.04.006. Epub 2015 Apr 30.


Objective: To evaluate the performance of the PAWPER (Pediatric Advanced Weight Prediction in the Emergency Room) tape, a new weight-estimation tool with a modifier for body habitus, in our increasingly obese population.

Study design: A convenience sample of children presenting to the pediatric emergency department of an urban public hospital was enrolled. A nurse or doctor assigned the patient a body habitus score and used the PAWPER tape to estimate the weight. The true weight was then recorded for comparison.The estimated weight was considered accurate if it was within 10% of the true weight.

Results: We enrolled 1698 patients; 579 (34%) were overweight or obese. Overall, the estimated weight was accurate for 64% of patients (95% CI 61%-65%). For children with an above-average body habitus, the tape was accurate 50% of the time (95% CI 46%-55%). There was no significant difference in the accuracy of the PAWPER tape for children assessed during medical and trauma resuscitations.

Conclusion: Although the PAWPER tape may ultimately be useful, its initial performance was not replicated in our population. A simple, accurate method of weight estimation remains elusive.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Anthropometry / instrumentation
  • Anthropometry / methods*
  • Body Weight*
  • Child
  • Child, Preschool
  • Emergency Service, Hospital
  • Female
  • Humans
  • Infant
  • Male
  • Overweight / diagnosis
  • Pediatric Obesity / diagnosis
  • Sampling Studies
  • Urban Population