The RAMA Ped Card： Does it work for actual weight estimation in child patients at the emergency department

BACKGROUND: In emergency conditions, the actual weight of infants and young children are essential for treatments. The RAMATHIBODI Pediatric Emergency Drug Card or RAMA Ped Card has also been developed to estimate actual weight of the subjects. This study aimed to validate the RAMA Ped Card in correctly identifying the actual weight of infants and young adults.METHODS: This study was a prospective study. We enrolled all consecutive patients under 15 years of age who visited the emergency department(ED). All eligible patients' actual weight and height were measured at the screening point of the ED. The weight of each patient was also measured using the unlabeled RAMA Ped Card. The Cohen's kappa values and agreement percentages were calculated.RESULTS: During the study period, there were 345 eligible patients. The RAMA Ped Card had a 61.16% agreement with the actual weight with a kappa of 0.54(P<0.01), while the agreement with the actual height had a kappa of 0.90 and 91.59% agreement. Sub-group analysis found kappa scores with good range in two categories: in cases of accidents and in the infant group(kappa of 0.68 and 0.65, respectively).CONCLUSION: The RAMA Ped Card had a fair correlation with the actual weight in child patients presenting at the ED. Weight estimation in infant patients and children who presented with accidents were more accurate.

Assessing Thai Hospitals’Evacuation Preparedness Using the Flexible Surge Capacity Concept and Its Collaborative Tool

According to the concept of“flexible surge capacity,”hospitals may need to be evacuated on two occasions:(1)when they are exposed to danger,such as in war;and(2)when they are contaminated,such as during the Covid-19 pandemic.In the former,the entire hospital must be evacuated,while in the latter,the hospital becomes a pandemic center necessitating the transfer of its non-contaminated staff,patients,and routine activities to other facilities.Such occasions involve several degrees of evacuation—partial or total—yet all require deliberate surge planning and collaboration with diverse authorities.This study aimed to investigate the extent of hospital evacuation preparedness in Thailand,using the main elements of the flexible surge capacity concept.A mixed method cross-sectional study was conducted using a hospital evacuation questionnaire from a previously published multinational hospital evacuation study.The tool contained questions regarding evacuation preparedness encompassing surge capacity and collaborative elements and an open-ended inquiry to grasp potential perspectives.All 143 secondary care,tertiary care,and university hospitals received the questionnaire;43 hospitals provided responses.The findings indicate glitches in evacuation protocols,particularly triage systems,the inadequacies of surge planning and multiagency collaboration,and knowledge limitations in community capabilities.In conclusion,the applications of the essential components of flexible surge capacity allow the assessment of hospital preparedness and facilitate the evaluation of guidelines and instructions through scenario-based training exercises.