Murphy listed criteria for triaging a child with bloody diarrhea. The author is from the University of Birmingham.
Patient selection: pediatric patient with bloody diarrhea
Parameters:
(1) number of bowel movements per day
(2) duration of diarrhea in days
(3) signs of systemic illness
(3a) fever
(3b) tachycardia
(3c) pallor
(4) signs and symptoms for acute abdomen
(4a) persistent or bilious vomiting
(4b) hematemesis
(4c) abdominal pain
(4d) abdominal tenderness
(4e) abdominal distention
(4f) palpable abdominal mass
|
Signs of Acute Abdomen |
Signs of Systemic Illness |
Number of Bowel Movements |
Duration of Diarrhea |
Evaluation |
|
1 or more |
NA |
NA |
NA |
urgent referral surgeon |
|
none |
1 or more |
NA |
NA |
urgent referral GI |
|
none |
NA |
>= 6 per day |
NA |
urgent referral GI |
|
none |
none |
< 6 per day |
>= 7 days |
GI |
|
none |
none |
< 6 per day |
recurrent |
GI |
|
none |
none |
< 6 per day |
< 7 days |
GP |
A child who appears well and who has mild to moderate bloody diarrhea (< 6 episodes per day) can be evaluated expectantly. The presence of severe diarrhea and/or worrisome signs and symptoms should prompt an urgent assessment.
|
Evaluator |
Workup |
|
general practitioner (GP) |
stool examination |
|
gastroenterologist (GI) |
endoscopy |
|
surgeon |
imaging studies and/or surgery |
Specialty: Pedatrics
ICD-10: ,
