Pedemy All toolsAnswer each finding. The score and plan appear at the end. Tap any earlier answer to change it.
This calculator works out the Pediatric Appendicitis Score (PAS) for a child with abdominal pain and suggests next steps. It is for clinicians in the emergency department or clinic.
The score has eight items worth up to 10 points. Migration of pain to the right lower quadrant, anorexia, nausea or vomiting, and temperature 38°C or higher each score 1 point. Right lower quadrant tenderness and pain with coughing, percussion or hopping each score 2 points. White cell count over 10,000/µL and neutrophils over 7,500/µL each score 1 point; if labs were not done they score 0, and the tool warns the true score may be higher.
A score of 0–3 is low risk, with discharge and return advice or observation. A score of 4–6 is intermediate and points to an appendix ultrasound. A score of 7–10 is high risk and calls for a surgical consult. The result also gives analgesia doses (IV morphine or intranasal fentanyl) and antibiotics once appendicitis is confirmed: ceftriaxone with metronidazole, or piperacillin-tazobactam if perforated. Score bands follow Samuel 2002 and the Goldman 2008 validation study.
Pain migrating to the right lower quadrant, anorexia, nausea or vomiting, fever of 38°C or higher, WBC over 10,000/µL and neutrophils over 7,500/µL each add 1 point. Right lower quadrant tenderness and pain with coughing, percussion or hopping each add 2 points, for a maximum of 10.
A score of 7–10 is high risk and the tool advises a surgical consult. A score of 4–6 is intermediate and suggests ultrasound; 0–3 is low risk.
The tool states that pain relief does not mask the diagnosis. It lists IV morphine 0.05–0.1 mg/kg or intranasal fentanyl 1.5 mcg/kg.
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