Patient selection: pediatric patient who has swallowed a caustic substance
Parameters:
(1) drooling saliva (D)
(2) reluctance (R) to ear, dysphagia or food intolerance
(3) oral or oropharyngeal (O) burns
(4) other (O) signs and symptoms (persistent fever, hematemesis, abdominal tenderness, retrosternal pain, dyspnea)
(5) leukocytosis (L)
|
Parameter
|
Finding
|
Points
|
|
drooling
|
yes, >= 12 hours
|
0
|
|
|
yes, < 12 hours
|
1
|
|
|
no
|
2
|
|
reluctance to eat
|
yes, >= 24 hours
|
0
|
|
|
yes, < 24 hours
|
1
|
|
|
no
|
2
|
|
oral/oropharyngeal burns
|
severe
|
0
|
|
|
edema, hyperemia
|
1
|
|
|
none
|
2
|
|
other signs and symptoms
|
>= 2
|
0
|
|
|
1
|
1
|
|
|
0
|
2
|
|
leukocytosis
|
>= 20,000 per µL
|
0
|
|
|
> ULN to 19,999 per µL
|
1
|
|
|
normal
|
2
|
where:
• Severe oropharyngeal burn: necrosis, ulceration, exudate/white membrane, hemorrhage, friability, blisters, etc.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score <= 4 is associated with esophageal stricture.
