Trauma Scoring

• Abbreviated Injury Score (AIS(

• Injury Severity Score (ISS(
Abbreviated injury scale (AIS)

Injury AIS Score

1 Mild
2 Moderate
3 Serious
4 Severe
5 Critical
6 Unsurvivable
Initial trauma management

Triage

• Sorting of patients based on the need for

treatment and the available resources to
provide that treatment.
• Based on ABC.
• On the field and medical facility.
• Appropriate patient transport.
 Glasgow coma score (GCS)

Eye opening Verbal response Motor response

Spontaneous = 4 Oriented = 5 Obeys commands = 6

To voice = 3 Confused = 4 Localizes stimuli = 5

To pain = 2 Inappropriate words = 3 Withdrawal = 4

None = 1 Incomprehensible sounds = Decorticate = 3

2
None = 1 Decerebrate = 2

None = 1
 The degree of blood loss
Class I Class II Class III Class IV

Blood loss (mL) Up to 750 750–1500 1500–2000 >2000

Blood loss (%) Up to 15% 15–30% 30–40% >40%

Pulse rate <100 >100 >120 >140

BP Normal Normal Decreased Decreased

RR 14–20 20–30 30–40 >40

Urine output >30 20–30 5–15 Negligible

(mL/hr)

Mental status Slightly Mild anxiety Anxious, Lethargic

anxious confused
grade type Liver Injury Scale
Description
I Hematoma Subcapsular, nonexpanding, < 10% surface area.
Laceration Capsular tear, nonbleeding; < 1 cm deep in parenchyma.

II Hematoma Subcapsular, on expanding, 10– 50% surface area; intraparenchymal,

nonexpanding, < 10 cm
Laceration Capsular tear, active bleeding; 1– 3 cm deep into the parenchyma, < 10
cm long.
III Hematoma Subcapsular, > 50% surface area or expanding or ruptured subcapsular
hematoma with active bleeding intraparenchymal hematoma > 2 cm or
expanding.
Laceration > 3 cm deep into the parenchyma.

IV Hematoma Ruptured intraparenchymal hematoma with active bleeding.

Laceration Parenchymal disruption involving > 50% of hepatic lobe.

V Laceration Parenchymal disruption involving > 50% of hepatic lobe.

Vascular Juxtahepatic venous injuries; ie, retro-hepatic vena cava or major
hepatic veins.
VI Vascular Hepatic avulsion.
 CT scan criteria for staging liver trauma based on the AAST liver injury
scale include the following:


• Grade 1 - Subcapsular hematoma less than 1 cm in maximal thickness,

capsular avulsion, superficial parenchymal laceration less than 1 cm
deep, and isolated periportal blood tracking
•
• Grade 2 - Parenchymal laceration 1-3 cm deep and
parenchymal/subcapsular hematomas 1-3 cm thick
•
• Grade 3 - Parenchymal laceration more than 3 cm deep and
parenchymal or subcapsular hematoma more than 3 cm in diameter
•
• Grade 4 - Parenchymal/subcapsular hematoma more than 10 cm in
diameter, lobar destruction, or devascularization
•
• Grade 5 - Global destruction or devascularization of the liver
•
• Grade 6 - Hepatic avulsion
•
 Spleen Trauma
Character Grade
Subcapsular hematoma I
Sub segmental parenchgmal II
injury
Segmental devitalization III
Polar disruption IV
Shattered or devascularized V
organ