Hot Off the Press: Comparison of Clinical Suspicion Versus a Clinical Prediction Rule When Evaluating Children Following Blunt Torso Trauma.

Abstract

Trauma is the leading cause of mortality among children in the United States. In spite of a lack of consensus guidelines, computed tomography (CT) has become the contemporary criterion standard for the evaluation of hemodynamically stable children following blunt torso trauma. In 2013, the Pediatric Emergency Care Applied Research Network (PECARN) derived a clinical prediction instrument consisting of seven findings from history and physical examination that could be used to identify children at very low risk (≤0.1%) for intra-abdominal injury (IAI) requiring intervention following blunt torso trauma: no evidence of abdominal or thoracic wall trauma, Glasgow Coma Scale score > 13, no abdominal tenderness, no abdominal pain, no decreased breadth sounds, and no history of vomiting. This prediction instrument has been awaiting external validation as well as comparison to other commonly used risk stratification methods such as clinical suspicion.