ED Decision Tools
Alvarado Score for Acute Appendicitis
Estimates the likelihood of acute appendicitis from history, exam, and labs (the MANTRELS criteria) to guide discharge, imaging, or surgical consult.
Symptoms
Migratory RLQ pain
Anorexia
Nausea or vomiting
Signs
RLQ tenderness
Rebound pain
Elevated temperature (≥37.3°C / 99.1°F)
Laboratory
Leukocytosis (WBC >10,000 /µL)
Left shift (>75% neutrophils)