Trauma Risk Stratification

Question 1

Which physiological score are use in assessment of a trauma patient?

Answer 1

○ Glasgow coma
○ Advanced trauma life support
○ Advanced trauma score

Question 2

What are the variables for the Glasgow coma scale?

Answer 2

Eye opening
Motor response
Verbal response

Question 3

How is severity graded with GCS

Answer 3

Question 4

How is severity graded with GCS

Answer 4

Question 5

Validation of the GCS

Answer 5

Probably, the best validation of its ability to do this was provided by the first CRASH Trial conducted worldwide between 1998 and 2002. ThistrialwasasimplerandomizedtrialofsteroidsinTBI.Ten thousand patients with suspected TBI and a Glasgow coma score (GCS) of ,15 in over 100 centres worldwide were recruited. Within the CRASH cohort, the GCS (3–14) was shown to have an almost linear relationship with 14 day mortality.2 Thesamestudyalsoshowedanalmostlinearrelationshipin the likelihood of a goodrecoveryafter injury (as definedbythe Glasgow outcome scale)3 at 6 months with ,10%of patientswith aGCSof4havingagoodrecoverycomparedwith70%of patientswithaGCSof14(I.Roberts,personalcommunication). There is no doubt about the central place of the GCS in assessing the likelihood of TBI and overall prognosis in trauma patients.

Question 6

What are the variables used in the revised trauma score?

Answer 6

respiratory rate,
systolic arterial pressure, and GCS.