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