Trauma Scoring Systems

Question 1

What is the Glascow coma scale?

Answer 1

Based on 3 variables:
Best Motor Response
6 - Obeys command
5 - Localizes pain
4 - Normal withdrawal (flexion)
3 - Abnormal withdrawal (flexion): decorticate
2 - Abnormal withdrawal (extension): decerebrate
1 - None (flaccid)
Best Verbal Response
5 - Oriented
4 - Confused conversation
3 - Inappropriate words
2 - Incomprehensible sounds
1 - None
Eye Opening
4 - Spontaneous
3 - To speech
2 - To pain
1 - None

brain injury
severe

Question 2

What is the revised trauma scale (RTS)?

Answer 2

most widely used prehospital field triage tool that uses:
GCS
SBP
RR
Each category goes from best (4) to worst (0); low score indicates more severity; RTS

Question 3

What is the injury severity score (ISS)?

Answer 3

Based on 9 anatomic areas with score from 0-6;
0 - no injury
1 - minor
2 - moderate
3 - severe (not life-threatening)
4 - severe (life-threatening, survival probable)
5 - severe (critical, survival uncertain)
6 - maximal, possibly fatal (automatic ISS of 75)
ISS is sum of squares of three most severely injured; goes from 1-75
ISS >15 has increased mortality

Question 4

What is the mangled extremity severity score?

Answer 4

Based on:
skeletal and soft tissue injury (graded 1-4)
limb ischemia (graded 1-3)
shock (graded 0-2)
age (graded 0-2)

used to predict necessity of amputation after lower extremity trauma; score 7 or greater is predictive of amputation

Question 5

What are the criteria for systemic inflammatory response syndrome?

Answer 5

1) heart rate > 90 beats/min
2) WBC count 12,000 cells/mm³
3) respiratory rate > 20 or PaCO2 38 C

Question 6

How females compare to males at 10yr follow up after polytrauma?

Answer 6

Females have:
decreased quality-of-life scores
increased PTSD rates
increased absentee sick days when compared to males

Question 7

Which patient has a higher risk of rehospitalization after a severe lower extremity trauma, amputees or reconstructees?

Answer 7

Those that have limb reconstruction