Objective To evaluate four paediatric weight estimation methods (APLS, Luscombe and Owens, Best Guess and Broselow tape) in order to determine which are accurate for weight estimation in South African children.

Method From a database of 2832 children aged 1–10 years seen at Red Cross Hospital in Cape Town, measured weight was compared to estimated weights from all four methods.

Results APLS formula and the Broselow Tape showed the best correlation with measured weight. Mean error was 3.3% for APLS (for 1–10-year olds) and 0.9% for Broselow tape (children <145 cm length and <35 kg). Both the Best Guess and Luscombe and Owens formulae tended to overestimate weight (15.4% and 12.4%, respectively).

Conclusion The Broselow tape and APLS estimation methods are most accurate in estimating weight in the Western Cape paediatric population, even though they have a small tendency to underestimate weight. Clinicians need to bear in mind that none of the formulae are infallible and constant reassessment and clinical judgement should be used, as well as a measured weight as soon as possible in an emergency situation.