Transcript Royal College of Paediatrics and Child Health Measuring and Plotting Measuring and Plotting using the new UK-WHO Growth Charts.

Royal College of Paediatrics and Child Health
Measuring and Plotting
Measuring and Plotting using
the new UK-WHO Growth
Charts
Measuring and plotting
Measuring Weight
Babies should be weighed without any
clothes or nappy
Children older than two years can be
weighed in vest and pants, but no shoes,
footwear, and dolls or teddies in hand
Only class III clinical electronic scales in
metric setting should be used
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Class III
Clinical
Electronic
Scales
Measuring and plotting
Measuring Head Circumference
Head circumference should be
measured using a narrow plastic or
disposable paper tape
Measurement should be taken
where the head circumference is
widest
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
Measuring Length
Measure length before age 2 years if concerned.
Use proper equipment (length board or mat) as any other
method is too inaccurate. Requires two measurers
Length should be measured without nappy or footwear.
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
Measuring Height
Height should be measured from
ages 2 years using a rigid rule with
T piece, or stadiometer.
Ensure heels, bottom, back and
head are touching the apparatus
with eyes and ears at 90º
Don’t try to stretch up, measure on
expiration
Always measure with
shoes removed.
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
Plotting the Chart
• Record measurement and date in ink, plot in pencil
• Use dot; do not join up
• Age errors are commonest source of plotting mistakes
use a calender or date wheel to calculate age
– Age in weeks for first 6-12 months
– Calendar months thereafter
• Count forward from the date of birth to current month using day of
birth eg if date of birth is 26/6/09, then age 13 months is on 23/7/10)
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
What do the Centiles Show?
• Optimum range of weights and heights
• Describes the percentage expected to be below that line
– 50% below 50th
– 91% below the 91st
– 1 in 250 below 0.4th
• Half of all children should be between 25-75th centile
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
Centile Terminology
If the point is exactly on the
centile line, or within ¼ of a
space of the centile line, the
child is described as being
‘on the X centile’ (see A)
e.g. on the 91st centile.
If not they should be
described as being ‘between
centile X and Y’ (see B) e.g.
between the 75th-91st centile.
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
Centile Spaces
A ‘centile space’ is the
distance between two centile
lines (e.g. C).
Two measurements can be
described as a centile space
apart if they are both midway
between centiles (e.g. D).
Falls or rises should be
expressed as multiples of
centile spaces (e.g. a fall
through 2½ centile spaces).
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
Summary: Measuring
•
•
•
•
•
Whoever measures a child should be suitably trained or be supervised
by someone who is
Weight
– Use only class III electronic scales
– Weigh babies naked, toddlers in vest and pants, without shoes
Head circumference
– Use narrow, paper or plastic tape round widest part of the head
Length (up to age 2)
– Proper equipment essential (length board or mat)
– Training particularly important
– Shoes and nappy removed
Height (after age 2)
– Rigid rule with T piece, or stadiometer, shoes removed
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting
Summary: Plotting and Centiles
• Record measurement and date in ink
• Plot in pencil
• Age errors are commonest source of plotting mistakes
• Centiles describes the percentage expected to be below
that line
• A child is
– on a centile if within ¼ space of line
– between the two centiles if not on (or within ¼ space of) a centile
• A centile space is the distance between two centile lines
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting: Activity 2 Answers
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting: Activity 2 Answers
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk
Measuring and plotting: Activity 2 Answers
© 2010 Royal College of Paediatrics and Child Health
www.growthcharts.rcpch.ac.uk