Trauma Index (TI)

Contains five variables:

Region of body injured
Type of injury
Cardiovascular status
CNS status
Respiratory status
Low scores correlated with minor injuries, whereas multiple system trauma victims
scored higher with higher
Mortality

CRAMS
10-point scale that measures 5 parameter:
Circulation
Respiratory
Abdomen
Motor
Speech
Each parameter scored as normal (2), mild abnormal (1) and severely abnormal (0)

Stimuli that initiate the physiologic response to trauma

Perception of pain
Shock
Blood loss
Hypoxia
Acidosis
Hypothermia
Mediators of physiologic response to trauma
Sympatho-adrenal axis
Hypothalamic-pituitary adrenal axis
Anti-diuretic Hormone
Renin and Angiotensin
Endogenous opioids
Locally produced Mediators
Trauma, results in alteration of nearly all physiologic systems
Physiologic Reponses
Psychologic response
Altered Vital Signs
Edema
 Impaired Oxygen Transport
Hypermetabolism
Altered Protein Metabolism
Altered Glucose Metabolism
Altered Coagulation & Inflammation
Leucocytosis
Altered Immunity

Trauma Management: Golden Hour

Time to reach operating room (or other definitive treatment)
Patients in their Golden Hour must
Be recognized quickly
3
Have only immediate life threats managed
Be transported to an appropriate facility
Survival depends on assessment skills
Good assessment results from
An organized approach
Clearly defined priorities
Understanding available resources