Ch 34: Multisystem Trauma

Practice flashcards covering definitions, severity criteria, and the Revised Trauma Score system for multisystem trauma management.

Multiple-trauma patient

A patient who has more than one serious injury.

Multisystem-trauma patient

A patient with one or more injuries serious enough to affect more than one body system.

Physiologic Criteria (Severity)

Criteria that include altered mental status ($GCS < 14$), hypotension (systolic blood pressure $< 90\,mmHg$), and abnormal respiratory rates.

Anatomic Criteria (Severity)

Criteria including amputations proximal to the wrist or ankle, pelvic fractures, open or depressed skull fractures, paralysis, chest wall instability/deformity, and penetrating injuries to the head, neck, or torso.

Mechanism of Injury (MOI) Criteria

Factors such as falls, high-risk auto crashes (intrusion, ejection, death in same compartment), or high-risk vehicle telemetry data used to determine severity in the absence of anatomic or physiologic signs.

Golden hour

The critical timeframe describing the need for trauma patients to get to surgery within $1$ hour of the injury occurring.

Trauma Scoring

A numerical rating system that assigns numbers to patient characteristics to objectively describe severity and help determine transport to a trauma center versus a local hospital.

Revised Trauma Score (RTS)

A trauma scoring method that includes the Glasgow Coma Scale ($GCS$), systolic blood pressure, and respiratory rate.

RTS Points: Glasgow Coma Scale (GCS)

Points assigned as: $13-15 = 4$, $9-12 = 3$, $6-8 = 2$, $4-5 = 1$, and $3 = 0$.

RTS Points: Systolic Blood Pressure

Points assigned as: $> 89\,mmHg = 4$, $76-89\,mmHg = 3$, $50-75\,mmHg = 2$, $1-49\,mmHg = 1$, and $0 = 0$.

RTS Points: Respiratory Rate

Points assigned as: $10-29$ per minute $= 4$, $> 29$ per minute $= 3$, $6-9$ per minute $= 2$, $1-5$ per minute $= 1$, and $0 = 0$.

Special Patient Considerations

Conditions that impact trauma triage, such as older adults not compensating well for shock, children potentially needing pediatric specialty facilities, pregnancy, or the use of anticoagulants.