PECARN_pediatric_intra_abdominal_injury_rule_guideline v.1
A prediction rule used to identify children at very low risk of clinically important blunt abdominal injuries.
To identify children at very low risk for intra-abdominal injuries undergoing acute intervention and minimize the use of computed-tomography (CT) scans in those patients.
Use to identify children at very low risk for intra-abdominal injuries undergoing acute intervention. The Pediatric Intra-Abdominal Injury (IAI) Algorithm predicts a 5.4% risk of IAI-intervention if there is evidence of abdominal wall trauma or seatbelt sign, or if GCS score is below 14 with blunt abdominal trauma. It predicts a 1.4% risk of IAI-intervention if the last condition is false but the patient suffers abdominal tenderness. It predicts a 0.7% risk of IAI-intervention if the last conditions are false but the patient has: thoracic wall trauma, abdominal pain, decreased breath sounds and vomits. It predicts a 0.1% risk of IAI-intervention if all the conditions mentioned are negative.
Not to be used in patients older than 18 years old. Not to be used in patients if they suffer the injury more than 24 hours before presentation. Not to be used in patients that met any of these: penetrating trauma, preexisting neurologic disorders, pregnancy, or they are transferred from another hospital with previous abdominal CT or diagnostic peritoneal lavage.
Holmes JF, Lillis K, Monroe D, Borgialli D, Kerrey BT, Mahajan P, Adelgais K, Ellison AM, Yen K, Atabaki S, Menaker J, Bonsu B, Quayle KS, Garcia M, Rogers A, Blumberg S, Lee L, Tunik M, Kooistra J, Kwok M, Cook LJ, Dean JM, Sokolove PE, Wisner DH, Ehrlich P, Cooper A, Dayan PS, Wootton-Gorges S, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med. 2013 Aug;62(2):107-116.e2. doi: 10.1016/j.annemergmed.2012.11.009. Epub 2013 Feb 1. PMID: 23375510. Springer E, Frazier SB, Arnold DH, Vukovic AA. External validation of a clinical prediction rule for very low risk pediatric blunt abdominal trauma. Am J Emerg Med. 2019 Sep;37(9):1643-1648. doi: 10.1016/j.ajem.2018.11.031. Epub 2018 Nov 23. PMID: 30502218.
EVALUATION.pediatric_intra_abdominal_injury_rule_assessment.v0, OBSERVATION.basic_demographic.v1, OBSERVATION.pediatric_intra_abdominal_injury_rule.v0
