The Pediatric Surgical Research Collaborative (PedSRC) reported a decision instrument for the evaluation of a pediatric patient with blunt torso trauma.
Patient selection: pediatric patient with blunt torso trauma
Parameters:
(1) serum AST in U/L
(2) abdominal wall trauma, tenderness or distension
(3) chest X-ray
(4) complain of abdominal pain
(5) serum pancreatic enzymes
Parameter
Finding
Points
serum AST
<= 200 U/L
0
> 200 U/L
1
abdominal wall trauma, tenderness or distension
no
0
yes
1
chest X-ray
normal
0
abnormal
1
abdominal pain
no
0
yes
1
serum pancreatic enzymes
normal
0
abnormal
1
total score =
= SUM(points for the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score of 0 indicates a very low risk of intra-abdominal injury and CT scan is usually not worthwhile.
Total Score
Any Intra-Abdominal Injury
Intra-Abdominal Injury Requiting Intervention
0
0.7%
0%
1
3.8%
1%
2
11.4%
3.6%
3
28.6%
5.7%
4 or 5
69.2%
20.5%
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