Table 2: RIPASA scale.

Data

Score

Male

1

Female

0.5

< 39.9 years

1

> 40 Years

0.5

Foreign National Registration Identity Card

1

Symptoms

 

Pain in RIF

0.5

Nausea/vomiting

1

Migratory pain

0.5

Anorexia

1

Symptoms < 48 hours

1

Symptoms > 48 hours

0.5

Signs

 

Hypersensitivity in RIF

1

Voluntary muscular resistance

2

Rebound

1

Rovsing

2

Fever > 37 oC < 39 oC

1

Laboratory

 

Leucocytosis

1

Negative urinalysis

1

Interpretation of RIPASA. According to the score, management is suggested:

• <5 points (unlikely): observation of the patient and applying a scale again in one to two hours, if the score decreases, the pathology is ruled out, if it increases, it is revalued with the score obtained .

• 5-7 points (low probability): observation in the emergency department and repeat the scale in one to two hours, or perform an abdominal ultrasound. Stay under observation.

• 7.5-11.5 points (high probability of acute appendicitis): evaluation by the surgeon and preparing the patient for an appendectomy, if he decides to continue the observation, it is repeated in one hour. In case of being a woman, assess ultrasound to rule out gynecological pathology.

• > 12 points (diagnosis of appendicitis): assessment by the surgeon for treatment or refer if necessary.

Source: Reyes, 2012.12