References

References & sources

Last reviewed June 2026 · reviewed at least every 12 months · Kim Trinh, MD, board-certified emergency medicine

Every risk tool in ER Toolkit names the validated clinical decision instrument it implements and cites that instrument’s original peer-reviewed derivation study. The instruments are the work of their respective authors; ER Toolkit only points to them and helps document their use. Always apply each rule only within its validated population and confirm against your current local guidance.

  • Alvarado score
    Alvarado A. Ann Emerg Med. 1986.
    Used in: Abdominal Pain
  • Burn-center referral criteria reviewed
    American Burn Association burn-center referral criteria.
    Used in: Burns
  • Canadian CT Head Rule
    Stiell IG, et al. Lancet. 2001.
    Used in: Head Injury
  • Canadian Syncope Risk Score
    Thiruganasambandamoorthy V, et al. CMAJ. 2016.
    Used in: Syncope
  • Centor / McIsaac score
    McIsaac WJ, et al. CMAJ. 1998.
    Used in: Sore Throat
  • CURB-65 severity score
    Lim WS, et al. Thorax. 2003.
    Used in: Cough / Possible Pneumonia
  • Glasgow-Blatchford score
    Blatchford O, et al. Lancet. 2000.
    Used in: GI Bleeding
  • HEART score
    Six AJ, Backus BE, Kelder JC. Neth Heart J. 2008.
    Used in: Chest Pain
  • HINTS exam (acute vestibular syndrome only)
    Kattah JC, et al. Stroke. 2009.
    Used in: Dizziness / Vertigo
  • Kocher criteria (septic hip)
    Kocher MS, et al. J Bone Joint Surg Am. 1999.
    Used in: Pediatric Limp / Refusal to Bear Weight
  • NEXUS C-spine criteria
    Hoffman JR, et al. N Engl J Med. 2000.
    Used in: Head Injury
  • NIHSS (stroke severity)
    Brott T, et al. Stroke. 1989.
    Used in: Stroke / acute focal deficit
  • Ottawa ankle & foot rules
    Stiell IG, et al. JAMA. 1993.
    Used in: Ankle & Knee Injury
  • Ottawa knee rule
    Stiell IG, et al. JAMA. 1996.
    Used in: Ankle & Knee Injury
  • Ottawa SAH rule
    Perry JJ, et al. JAMA. 2013.
    Used in: Headache
  • Outpatient BP plan (ACEP-consistent)
    ACEP Clinical Policy: Asymptomatic Elevated Blood Pressure. Ann Emerg Med. 2013.
    Used in: Elevated Blood Pressure
  • PECARN pediatric head-injury criteria
    Kuppermann N, et al. Lancet. 2009.
    Used in: Pediatric Head Injury
  • PERC rule (PE)
    Kline JA, et al. J Thromb Haemost. 2004.
    Used in: Chest Pain, Dyspnea
  • qSOFA
    Seymour CW, et al. JAMA. 2016.
    Used in: Fever / Possible Sepsis
  • Rabies PEP decision documented
    CDC ACIP rabies post-exposure prophylaxis recommendations.
    Used in: Bite, Sting & Tick Exposure
  • Structured risk screen (C-SSRS or equivalent)
    Posner K, et al. Am J Psychiatry. 2011.
    Used in: Suicidal Ideation / Self-harm
  • Timed acetaminophen level (≥ 4 h)
    Rumack BH, Matthew H. Pediatrics. 1975.
    Used in: Overdose / Ingestion
  • TWIST score (torsion)
    Barbosa JA, et al. J Urol. 2013; Qin KR, et al. J Urol. 2022 (meta-analysis).
    Used in: Testicular / Scrotal Pain
  • Verbal de-escalation attempted first
    Project BETA. West J Emerg Med. 2012.
    Used in: Agitation / Acute Psychosis
  • Wells score (PE)
    Wells PS, et al. Thromb Haemost. 2000.
    Used in: Chest Pain, Dyspnea

25 instruments cited. Decision-rule content is re-checked against current guidance on each review; if a rule is superseded, the tool and this list are updated.