Measuring Weight/height in ED routinely

[reholi4]

good evening,

i would just like to find out if your emergency departments measure weight/height on all patients coming into the emergency department.

in my experience we only need to measure weight in chilideren as all treatments are based on weight.

your comments will be appreciated.

thanks,

[Lunah, MSN, RN]

We get weights on all children. We ask all adult patients for an estimated weight. If we have adult patients who require a weight-based drug therapy like Lovenox or tPA, we obtain a weight on them as well.

[GilaRRT]

We probably should. Height is actually very important when considering ventilator management and setup. The various volume and spaces are based on ideal body weight, and IBW is based on height.

[RelloydRN]

I agree with the above post. A good nursing assessment is a COMPLETE assessment. Both height and weight should be obtained if possible.

[bill4745, RN]

In my experience we only need to measure weight in children as all treatments are based on weight.

Ditto. There isn't enough time to weigh and get a height on everyone.

[Larry77, RN]

I agree with the above post. A good nursing assessment is a COMPLETE assessment. Both height and weight should be obtained if possible.

This is a silly statement to me....you want us to measure and weigh EVERY adult patient? In the ED we do focused assessments not "complete" assessments, you come in with a sore throat, that is what we are going to focus on, we are not going to measure and weigh you unless we need to give you weight based meds (this is why we weigh kids).

[GilaRRT]

As I stated, we probably should get a height and weight if possible. It sucks when a seemingly "stable" person goes down and you are left guessing medication doses doing a look loo and saying "well I think he weighs this much.". I understand the barriers and constraints; however, in an ideal world every parent should have a current height and weight. This should be part of the basic triage process.

[RelloydRN]

This is a silly statement to me....you want us to measure and weigh EVERY adult patient? In the ED we do focused assessments not "complete" assessments, you come in with a sore throat, that is what we are going to focus on, we are not going to measure and weigh you unless we need to give you weight based meds (this is why we weigh kids).

That's why my post says "...if possible". In our facility, if you are unable to check the height and weight of the patient you also have to document why you have not taken them. Also, the quality department would have their eyes on you if you keep skipping assessments. The reason "Focused Assessments" don't work for them unless you really have a good reason not to take the height and weight (e.g. combative patients, patient refused etc.)

[GM2RN]

As I stated, we probably should get a height and weight if possible. It sucks when a seemingly "stable" person goes down and you are left guessing medication doses doing a look loo and saying "well I think he weighs this much.". I understand the barriers and constraints; however, in an ideal world every parent should have a current height and weight. This should be part of the basic triage process.

"Getting" a weight isn't the same as weighing everyone. We ask everyone who comes in through triage how much they weigh and how tall they are; this takes only seconds. We only weigh them if they don't know. Parents are asked how much their child weighs. If the parent doesn't know or is hesitant, then we weigh the child. I agree it's important to have a height and weight, but it isn't necessary to actually weigh and measure everyone.

[GM2RN]

That's why my post says "...if possible". In our facility, if you are unable to check the height and weight of the patient you also have to document why you have not taken them. Also, the quality department would have their eyes on you if you keep skipping assessments. The reason "Focused Assessments" don't work for them unless you really have a good reason not to take the height and weight (e.g. combative patients, patient refused etc.)

I agree with Larry about focused assessments. They are perfectly valid in the ED and doing them does NOT mean that assessments are skipped, or that a height and weight is not obtained.

[GM2RN]

I agree with the above post. A good nursing assessment is a COMPLETE assessment. Both height and weight should be obtained if possible.

A focused assessment IS a COMPLETE assessment in the ED.

If you are a new nurse, I can see where you might want to do a head-to-toe assessment on your patients until you get comfortable with more focused ones. Otherwise, HTT assessments waste precious time in the ED when they are not necessary.

[GilaRRT]

"Getting" a weight isn't the same as weighing everyone. We ask everyone who comes in through triage how much they weigh and how tall they are; this takes only seconds. We only weigh them if they don't know. Parents are asked how much their child weighs. If the parent doesn't know or is hesitant, then we weigh the child. I agree it's important to have a height and weight, but it isn't necessary to actually weigh and measure everyone.

Let me say this yet again. In a perfect world, we should have a current height and weight on our patients. Does it happen, nope. Should it happen, yes.