The ISS was introduced in 1974 as a method for describing patients with multiple injuries and evaluating emergency care.Injury Severity Score (ISS) and New Injury Severity Score (NISS) When used alone, the current AIS version is not useful for predicting patient outcomes or mortality instead, it forms the basis of the Injury Severity Score (ISS) and the Trauma and Injury Severity Score (TRISS).The AIS scale does not represent a linear scale, ie the difference between AIS1 and AIS2 is not the same as the difference between AIS4 and AIS5.The AIS scale does not provide a comprehensive measure of severity.The following is one example: Triage sieve Additional patient triageįollowing the initial triage, there is usually a further detailed pre-hospital triage of patients. One such score is called the Revised Trauma Score (see below). Once further resources are available to hand, the patients will undergo a further, more detailed triage based on vital signs - eg, respiratory rate. The need for effective triage systems to inform the use of intensive care resources was particularly highlighted during the COVID-19 pandemic. Triage systems are most often used following trauma incidents but may be required in other situations, such as an influenza epidemic. This arose from the finding that many lives could be saved by giving the control of haemorrhage and correction of hypovolaemia pre-eminence over airways control and other resuscitative measures. The cABCDE system has been used in the military for a number of years - the initial 'c' standing for catastrophic haemorrhage. The 'P' prefix is used by civilian services and the 'T' prefix by the military. Dead is a fourth classification and is important to prevent the expenditure of limited resources on those who are beyond help.P3 or T3: delayed care - needs medical treatment but this can safely be delayed.P2 or T2: intermediate or urgent care needed - requires significant intervention within two to four hours.Priority 1 (P1) or Triage 1 (T1): immediate care needed - requires immediate life-saving intervention.The following is one example of triage sieve which is used in the UK : Priority is then given to patients most likely to deteriorate clinically and triage takes account of vital signs, pre-hospital clinical course, mechanism of injury and other medical conditions.Triage is a dynamic process and patients should be reassessed frequently. *A growing body of evidence indicates the need to reconsider the routine use of cervical collars and rigid backboards in pre-hospital trauma care. Exposure or undressing of the patient while also protecting the patient from hypothermia.Circulation (including the control of external haemorrhage).Airway control with stabilisation of the cervical spine*.The primary survey aims to identify and immediately treat life-threatening injuries and is based on the 'ABCDE' resuscitation system: Triage is repeated prior to transport away from the scene and again at the receiving hospital. Primary triage is carried out at the scene of an accident and secondary triage at the casualty clearing station at the site of a major incident. Trauma triage is the use of trauma assessment for prioritising of patients for treatment or transport according to their severity of injury. For advanced adult trauma life support (ATLS), see the separate Trauma Assessment article.
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