I've been doing some pediatric safe dosage range questions and in my book the weight is first converted to kg and rounded to the nearest 10th then you proceed with the math problem. This is the way we were taught in school. While reading some other books it said to round pediatric weight to nearest hundredth. And other books the weight is not rounded at all. So is it correct to round pediatric weight to nearest 10kg then proceed with math problem?
To the nearest 10 kg? Most definitely not. The nearest 10th? In an older child, maybe. In an infant or preemie, probably not.
When I worked in the hospital, our infant scales went to the 3rd decimal point, the standard scale for older kids went to 1. Infant weights were definitely documented and used for calculation out to the 3rd decimal point. Preemies sometimes weigh less than 1 kg, rounding could lead to a very significant dose change. For example, you have a preemie who weights 851 g. If you use this to calculate a drug that's dosed at 100 mg/kg, your baby's dose is 85 mg. If you round to 900 g/0.9 kg, the dose of that medication is now 90 mg. For a baby that small, that could be significant.
At most, I will round to the nearest 0.1 kg in a patient who is over 10 kg.
If they are under 10 kg, I keep either 2 or 3 decimal points.
Rounding to the nearest kilo or more is only for near-adult sized patients in emergency situations.