1. Emergency Medical Technician - Basic
5/6/2019
Trauma Scoring
Emergency Medical Technician - Basic
EMS Professions
Temple College EMS Professions

2. Trauma Score Uses Triage Assessment Level I Trauma Center?
Air Transport?
Assessment
Tracking condition changes
EMS Professions

3. Trauma Score Uses Outcomes assessment
Severity reporting to on-line medical control, receiving facility
Research
Outcomes assessment
Quality assurance
EMS Professions

4. Scoring Factors Physiological Status Circulation/Perfusion Airway
Presence
Adequacy
Disability
Physiological Status
Airway
Breathing
Presence
Adequacy
EMS Professions

5. Scoring Factors Mechanism of Injury Kinematics
Type, direction, amount of force
EMS Professions

6. Scoring Factors Anatomical Site of Injury
Not accurate by self for pre-hospital use
Visible soft tissue/ orthopedic injury may distract from head, chest, abdominal trauma
Penetrating trauma depth/direction deceiving
Blunt trauma assessment difficult, especially abdomen
EMS Professions

7. Scoring Factors Anatomical Site of Injury
Penetrating trauma Chest, abdomen, head, neck, groin
> 2 long bone fractures
Burns >15% BSA, face, airway
Flail chest
Scalping injury
Paralysis
Amputation proximal to wrist/ankle
EMS Professions

8. Scoring Factors Co-morbid Factors
Burns associated with other major trauma
Age < 5 or > 55
Known cardiac, respiratory disease
Prolonged extrication/transport time
EMS Professions

9. Scoring Factors Logistics Extrication >20 minutes
Inaccessible scene
Long transport time
EMS Professions

10. Scoring Factors Kinematics--Motor Vehicle Collisions Speed >20 MPH
Rearward displacement of front axle
Deformity of auto >20 inches
Passenger compartment intrusion
>15 inches - patient side
>20 inches - opposite side
EMS Professions

11. Scoring Factors Kinematics--Motor Vehicle Collisions Rollover
Ejection from vehicle
Death/Serious injury of same car occupant
EMS Professions

12. Scoring Factors Kinematics--Pedestrian vs Vehicle Kinematics--Falls
Struck at >20 mph
Thrown > 15 feet
Child < 12 years old
Kinematics--Falls
>15 feet or >3x victim’s height
EMS Professions

13. Scoring Factors If any of scoring factors present:
Patient will require Level I or II Trauma Center
If transport time >20 minutes consider calling helicopter
EMS Professions

14. Commonly Used Prehospital Trauma Score
Revised Trauma Score
Commonly Used Prehospital Trauma Score
EMS Professions

15. Revised Trauma Score RTS component scores based on:
Glasgow scale
Respiratory rate
Systolic BP
Add component scores to determine RTS
EMS Professions

16. Glasgow Coma Scale Motor Response 1 = No response
2 = Abnormal extension
3 = Abnormal flexion
4 = Withdrawal
5 = Localizes pain
6 = Follows instructions
EMS Professions

17. Glasgow Coma Scale Verbal Response 1 = No response
2 = Incomprehensible sounds
3 = Inappropriate words
4 = Confused, disoriented
5 = Oriented
EMS Professions

18. Glasgow Coma Scale Eye Response 1 = No response 2 = To pain
3 = To verbal command
4 = Spontaneous
EMS Professions

19. Glasgow Coma Scale Motor + Verbal + Eye = Glasgow Score
What is lowest possible GCS Score?
EMS Professions

20. Revised Trauma Score Glasgow Coma Scale 0 = 1 - 3 GCS 1 = 4 - 5 GCS
EMS Professions

21. Revised Trauma Score Respiratory Rate 0 = 0 Respirations
1 = 1 to 5 Respirations
2 = 6 to 9 Respirations
3 = >29 Respirations
4 =10 to 29 Respirations
EMS Professions

22. Revised Trauma Score Systolic BP 0 = 0 1 = 1 to 49 2 = 50 to 75
4 = >89
EMS Professions

23. Revised Trauma Score
GCS score + Respiratory score + Systolic BP score = Revised Trauma Score
EMS Professions