Paediatrics · Emergency Medicine

PECARN Pediatric Blunt Abdominal Trauma Rule calculator

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Result

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Very low risk: none of the 7 predictors

Band: Very low risk: none of the 7 predictors

Interpretation. Very low risk: none of the 7 predictors

Suggested management. Children with blunt torso trauma and none of the 7 findings are at very low risk of intra-abdominal injury needing acute intervention: 6 of 5,034 (0.1%) in the derivation study (NPV 99.9%).

PECARN Pediatric Blunt Abdominal Trauma Rule: 0 — Very low risk: none of the 7 predictors. Interpretation: Very low risk: none of the 7 predictors What to do: Children with blunt torso trauma and none of the 7 findings are at very low risk of intra-abdominal injury needing acute intervention: 6 of 5,034 (0.1%) in the derivation study (NPV 99.9%). Inputs: Evidence of abdominal wall trauma or seat belt sign: false; Glasgow Coma Scale score <14: false; Abdominal tenderness: false; Evidence of thoracic wall trauma: false; Complaints of abdominal pain: false; Decreased breath sounds: false; Vomiting: false Source: Holmes JF, Lillis K, Monroe D, et al. Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med. 2013;62(2):107-116.e2. DOI: 10.1016/j.annemergmed.2012.11.009. PMID: 23375510. Scope: Children <18 years with blunt torso trauma. Seven variables in descending order of importance: evidence of abdominal wall trauma or seat belt sign; Glasgow Coma Scale score <14; abdominal tenderness; evidence of thoracic wall trauma; complaints of abdominal pain; decreased breath sounds; vomiting. With none present the child is at very low risk of intra-abdominal injury undergoing acute intervention (IAI-I): 6 of 5,034 rule-negative children had IAI-I (NPV 99.9%, sensitivity 97% for IAI-I). (2013)

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Source: Holmes JF, Lillis K, Monroe D, et al. Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med. 2013;62(2):107-116.e2. DOI: 10.1016/j.annemergmed.2012.11.009. PMID: 23375510. Scope: Children <18 years with blunt torso trauma. Seven variables in descending order of importance: evidence of abdominal wall trauma or seat belt sign; Glasgow Coma Scale score <14; abdominal tenderness; evidence of thoracic wall trauma; complaints of abdominal pain; decreased breath sounds; vomiting. With none present the child is at very low risk of intra-abdominal injury undergoing acute intervention (IAI-I): 6 of 5,034 rule-negative children had IAI-I (NPV 99.9%, sensitivity 97% for IAI-I). (2013)

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Clinical inputs

Evidence of abdominal wall trauma or seat belt sign
Glasgow Coma Scale score <14
Abdominal tenderness
Evidence of thoracic wall trauma
Complaints of abdominal pain
Decreased breath sounds
Vomiting

Primary source

Holmes JF, Lillis K, Monroe D, et al. Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med. 2013;62(2):107-116.e2. DOI: 10.1016/j.annemergmed.2012.11.009. PMID: 23375510. Scope: Children <18 years with blunt torso trauma. Seven variables in descending order of importance: evidence of abdominal wall trauma or seat belt sign; Glasgow Coma Scale score <14; abdominal tenderness; evidence of thoracic wall trauma; complaints of abdominal pain; decreased breath sounds; vomiting. With none present the child is at very low risk of intra-abdominal injury undergoing acute intervention (IAI-I): 6 of 5,034 rule-negative children had IAI-I (NPV 99.9%, sensitivity 97% for IAI-I). (2013)

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