Indications

• Rule-in test for appendicitis
• Clinical suspicion for appendicitis including but not limited to:
  • Right lower quadrant pain
  • Guarding and rebound tenderness
  • Fever, nausea, vomiting
  • Anorexia
  • Migratory pain from periumbilical region
  • Positive risk calculation (Alvarado score, Pediatric Appendicitis Score, Pediatric Appendicitis Risk Calculator (pARC)) [13-15]

PoCUS is appropriate in the same clinical scenarios that radiology-based imaging would be indicated. Physicians might elect to perform POCUS when this imaging is not available or timely, or in cases where POCUS might facilitate treatment or transfer decisions and expedite care.

 

Equipment

• Ultrasound machine
• High frequency linear probe (curvilinear probe for obese or older children)
• Ultrasound gel