Dia Gainor, NASEMSO
National EMS System Information System (NEMSIS) Version 3.0 Compliant Out-of-Hospital Records Emergency Department Discharge Databases Hospital Discharge Databases Trauma Registries
Physiological scoring systems Glasgow coma scale Trauma score Revised trauma score TRISS methodology Anatomical scoring systems Abbreviated injury score Injury severity score ICD-9 Injury Severity Score
Calibrated by the Association for the Advancement of Automotive Medicine First developed in 1969 Anatomically based Consensus derived Updated every five years Has been adopted by numerous other countries
1 = Minor 2 = Moderate 3 = Serious 4 = Severe 5 = Critical 6 = Maximum (Untreatable)
Head/neck Face Chest Abdomen Extremity External (skin)
ONLY highest AIS number in each body area is used 3 most severely injured body region scores squared 3 squared scores added together = Injury Severity Score
If injury is assigned a 6 (unsurvivable), ISS automatically = 75 Score Reflective of Injury Severity Minor Moderate Moderate/Severe ≥ 25 Severe/Critical
Many different injury patterns yield same ISS score Errors of AIS scoring = errors of ISS Injuries to different body regions are not weighted Limits the number of contributing injuries to 3 Can’t account for multiple injuries to the same body region
Anatomical scoring system for patients with multiple injuries ISS score correlates with mortality, morbidity & hospital stay Bivariate correlation of mortality % with ISS and age
Dia Gainor, NASEMSO Executive Director