Trauma is caused by a wide variety of risks e.g. fall ,agricultural related injuries, fire arm injuries, poisoning, burns, drowning, intentional self-harm (suicides), assault, fall of object, natural and man-made disasters.
retrospective analysis of a prospectively maintained database from Injury surveillance and Trauma registry forms maintained at JPN Apex Trauma Center, AIIMS
To calculate an ISS, take the highest AIS severity code in each of the three most severely injured ISS body regions, square each AIS code and add the three squared numbers for an ISS
Pattern of Injury severity and Probability of survival of RED Triaged Patients in an Apex Level 1 Trauma Centre Sonia Chauhan (Trauma Nurse Coordinator) J P N Apex Trauma Center,AIIMS [email_address]
A n anatomically based consensus-derived global severity scoring system that classifies each injury in every body region (head and neck including cervical spine, face ,chest , Abdomen with pelvic contents ,extremities, external)
according to its relative severity on a six point ordinal scale: 1 Minor, 2 Moderate, 3 Serious, 4 Severe, 5 Critical, 6 Maximal (currently untreatable).
New Injury severity Score (NISS ) : The New ISS (NISS ) is defined as the sum of the squares of the AIS of each of the patient’s three most severe AIS injuries, regardless of the body region in which they occur
NISS better predicts survival and is easier to calculate than ISS*
* Baker SP, O’Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974; 14: 187–196
N.G.Biligen et al studied ‘ The usefulness of trauma scores in determining the life threatening condition of trauma victims for writing medical-legal reports’ and concluded that Trauma scores can be used for making more objective, standardized, and accurate judgment on whether the injury was a life threatening one or not which was similar to our results.*
* Emergency Medicine Journalemj.bmj.com Emerg Med J 2005;22:783-787 doi:10.1136/emj.2004.019711
The non-survivor group had higher avg. ISS and NISS as compared to survivor group; moreover the ED death group had a higher avg. ISS and NISS within the non-survivor group.
The mortality rates of severely injured patients are very high and can be attributed primarily to the lack of systems approach and absence of Pre-hospital care which delays the transfer of the patients to the hospital.