Suspected Appendicitis Clinical Pathway – Emergency Department
Suspected Appendicitis Clinical Pathway – Emergency Department
Clinical Appendicitis Scores
Experienced physician's clinical impression is comparable to these scores.
Pediatric Appendicitis Risk (pARC) Calculator Variables
- Age, sex, temperature, nausea and/or vomiting
- Pain duration, pain location, pain with walking, pain migration, guarding
- WBC and ANC
pARC: Pediatric Appendicitis Risk Calculator
The Pediatric Appendicitis Score
| Pediatric Appendicitis Score (PAS) Low-Risk < 4; High-Risk ≥ 7 |
|
|---|---|
| Nausea/vomiting | 1 |
| Anorexia | 1 |
| Migration of pain to RLQ | 1 |
| Fever | 1 |
| Cough/percussion/hopping tenderness | 2 |
| RLQ tenderness | 2 |
| Leukocytosis (WBC > 10,000) | 1 |
| Neutrophilia (ANC > 7,500) | 1 |
| Low-Risk PAS < 4 High-Risk PAS > 7 Indeterminate-Risk PAS 4–6 | |
Low-Risk Appendicitis Score
| Refined Low-Risk Appendicitis Score |
|---|
| Absence of maximal tenderness in RLQ or RLQ tenderness without pain on walking, jumping or coughing and ANC < 6750/mm3 |
| NPV 95% for identifying children without appendicitis |