ED Decision Tools
Pediatric Appendicitis Score (PAS)
Estimates the likelihood of acute appendicitis in children (ages 4–18) to guide discharge, ultrasound/MRI, or surgical consult — tuned for peds, where the Alvarado score underperforms.
Symptoms
Migration of pain to RLQ
Anorexia
Nausea or vomiting
Signs
RLQ tenderness to cough, percussion, or hopping
RLQ tenderness on palpation
Fever ≥38°C (100.4°F)
Laboratory
Leukocytosis (WBC >10,000 /µL)
Neutrophilia (>75% PMNs)