The Cardiovascular
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PedSRC Rule for Blunt Abdominal Trauma

Identifies children at very low risk of intra-abdominal injury.

PedSRC Rule for Blunt Abdominal Trauma
Hypotension for age
Abnormal abdominal exam (wall trauma, tenderness or distension)
AST >200 U/L
Haematocrit <30%
Abnormal pancreatic enzymes (elevated amylase or lipase)
Microscopic haematuria (>5 RBC/hpf)
ResultVery low risk

No variables present. Risk of intra-abdominal injury is about 1% (NPV ~98.8%); abdominal CT can often be avoided.

Variables present
0 of 6

When to use

  • Deciding whether abdominal CT can be safely avoided in a haemodynamically evaluable child after blunt abdominal trauma.

Formula

Six high-risk variables: hypotension for age, abnormal abdominal exam, AST >200 U/L, haematocrit <30%, abnormal pancreatic enzymes, microscopic haematuria. Absence of all = very low risk.

Pearls and pitfalls

  • The rule identifies who can avoid CT; it is not intended to mandate CT when a variable is present.

References

  1. Streck CJ, et al. Identifying children at very low risk for blunt intra-abdominal injury in whom CT can be avoided. J Am Coll Surg. 2017;224(4):449-58.