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In 2013, the Pediatric Emergency Care Applied Research Network developed a prediction rule to identify patients who were at low risk of requiring acute intervention after blunt abdominal trauma. Interventions included laparotomy, embolization, blood transfusion or IV fluids for more than 2 nights with pancreatic or bowel injuries.
If ALL of the following are true, the patient is considered very low risk (0.1%) of needing an acute abdominal intervention:
- No evidence of abdominal wall trauma or seat belt sign
- GCS 14 or 15
- No abdominal tenderness
- No thoracic wall trauma
- No abdominal pain
- No decreased breath sounds
- No vomiting
This prediction rule was externally validated in 2018 showing a sensitivity of 99%. This rule should be used to decrease the rate of CT scans of the abdomen following blunt trauma.
References
Fornari M and Lawson S. Pediatric Blunt Abdominal Trauma and Point of Care Ultrasound. Pediatric Emergency Care 2021. 37 (12): 624-629.