Trauma Scoring Systems Flashcards
What is the definition of major trauma?
Injury Severity Score of more than 15
What are the Abbreviated Injury Score regions?
head, spine, face, thorax, abdomen, upper/lower extremity, external?
How is the AIS coded?
1 - Minor 2 - Moderate 3 - Serious 4 - Severe 5 - Critical 6 - Incompatible with life (max)
Give example of AIS 1?
Scalp contusion
Knife in eyeball
Give example of AIS 2?
Fractured sternum
Give example of AIS 3?
Knife in frontal lobe
If more than 50% of the spleen is involved in a sub capsular haematoma
Open fracture of humerus
Displaced upper tibial fracture
Give example of AIS 4?
Perforated trachea
Major liver laceration
Small subdural haematoma
Give example of AIS 5?
Ruptured liver with tissue loss
Give example of AIS 6?
Total Severance of Aorta
Revised Trauma Score?
Sum of weighted coded value of:
GCS (more important)
RR
SBP
When is RTS used?
RTS in major incident triage - avoids bias due to presentation of injuries
When was AIS made?
1971
Latest AIS?
2005, update 2008
PoS with RTS
Probability of survival with RTS
Max RTS?
7.84
ASCOT study?
10% mortality if ISS was higher than 15
What is TARN?
Trauma Audit Research Network
Methodology in TARN?
Trist methodology: Trauma Score Injury Severity Score
B are coefficients for blunt and penetrating trauma.
Ps = e to the power b/1 + e to the power b
B = B0 + B1
What is Ps14 in TARN?
- Includes pre-existing medical conditions (Charlston weighting)
- Excludes SBP/RR, only GCS
(And ISS)
What is Ws?
Standardisation of injury severity
What is w
What is Z
What is M?
w: Actual - Predicted survival rate
Z: statistical significance of this difference
M: measure of injury severity similarity and prediction database
What does the red dot mean?
what your Ws statistic is and how that compares with our centres. Used for funding/politics.
Funnel plot: precision.
What does the red dot mean?
what your Ws statistic (Actual-Predicted survival rate is) is and how that compares with our centres. Used for funding/politics.
Funnel plot: precision.
What does TARN miss?
Nothing about time to diagnosis/presentation
Write about injuries that were fixed pre-hospitably - otherwise skew data so not include those who did have ISS of more than 15, but not by the time they were in hospital.
If you die pre-hospitally, do not make it to TARN data.
Example of inclusion criteria on TARN website?
Admission to hospital for 3 days
DAI in shaken baby syndrome due to what?
hypoxia not trauma?
What did the NCEPOD report of 2006 say?
National Confidential Enquiry Into Patient Outcomes and Death:
quality of coroner’s autopsy reports. Basically autopsies not as definitive as assumed
