Trauma Scoring Systems

Question 1

What is the definition of major trauma?

Answer 1

Injury Severity Score of more than 15

Question 2

What are the Abbreviated Injury Score regions?

Answer 2

head, spine, face, thorax, abdomen, upper/lower extremity, external?

Question 3

How is the AIS coded?

Answer 3

1 - Minor
2 - Moderate
3 - Serious
4 - Severe
5 - Critical
6 - Incompatible with life (max)

Question 4

Give example of AIS 1?

Answer 4

Scalp contusion

Knife in eyeball

Question 5

Give example of AIS 2?

Answer 5

Fractured sternum

Question 6

Give example of AIS 3?

Answer 6

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

Question 7

Give example of AIS 4?

Answer 7

Perforated trachea
Major liver laceration
Small subdural haematoma

Question 8

Give example of AIS 5?

Answer 8

Ruptured liver with tissue loss

Question 9

Give example of AIS 6?

Answer 9

Total Severance of Aorta

Question 10

Revised Trauma Score?

Answer 10

Sum of weighted coded value of:
GCS (more important)
RR
SBP

Question 11

When is RTS used?

Answer 11

RTS in major incident triage - avoids bias due to presentation of injuries

Question 12

When was AIS made?

Answer 12

1971

Question 13

Latest AIS?

Answer 13

2005, update 2008

Question 14

PoS with RTS

Answer 14

Probability of survival with RTS

Question 15

Max RTS?

Answer 15

7.84

Question 16

ASCOT study?

Answer 16

10% mortality if ISS was higher than 15

Question 17

What is TARN?

Answer 17

Trauma Audit Research Network

Question 18

Methodology in TARN?

Answer 18

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

Question 19

What is Ps14 in TARN?

Answer 19

• Includes pre-existing medical conditions (Charlston weighting)
• Excludes SBP/RR, only GCS

(And ISS)

Question 20

What is Ws?

Answer 20

Standardisation of injury severity

Question 21

What is w
What is Z
What is M?

Answer 21

w: Actual - Predicted survival rate

Z: statistical significance of this difference

M: measure of injury severity similarity and prediction database

Question 22

What does the red dot mean?

Answer 22

what your Ws statistic is and how that compares with our centres. Used for funding/politics.
Funnel plot: precision.

Question 23

What does the red dot mean?

Answer 23

what your Ws statistic (Actual-Predicted survival rate is) is and how that compares with our centres. Used for funding/politics.
Funnel plot: precision.

Question 24

What does TARN miss?

Answer 24

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.

Question 25

Example of inclusion criteria on TARN website?

Answer 25

Admission to hospital for 3 days

Question 26

DAI in shaken baby syndrome due to what?

Answer 26

hypoxia not trauma?

Question 27

What did the NCEPOD report of 2006 say?

Answer 27

National Confidential Enquiry Into Patient Outcomes and Death:
quality of coroner’s autopsy reports. Basically autopsies not as definitive as assumed