1. Dia Gainor, NASEMSO

2.  National EMS System Information System (NEMSIS) Version 3.0 Compliant Out-of-Hospital Records  Emergency Department Discharge Databases  Hospital Discharge Databases  Trauma Registries

3.  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

4.  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

5.  1 = Minor  2 = Moderate  3 = Serious  4 = Severe  5 = Critical  6 = Maximum (Untreatable)

7.  Head/neck  Face  Chest  Abdomen  Extremity  External (skin)

8.  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

12.  If injury is assigned a 6 (unsurvivable), ISS automatically = 75  Score Reflective of Injury Severity  1 - 9 Minor  10 - 15 Moderate  16 - 24 Moderate/Severe  ≥ 25 Severe/Critical

13.  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

14.  Anatomical scoring system for patients with multiple injuries  ISS score correlates with mortality, morbidity & hospital stay  Bivariate correlation of mortality % with ISS and age

15. Dia Gainor, NASEMSO Executive Director dia@nasemso.org 208-861-4841