The Abbreviated Injury Scale (AIS) is an anatomical scoring system. Injuries are ranked on a scale of 1 to 6, with 1 being minor, 5 severe and 6 an unsurvivable injury.
The Injury Severity Score (ISS) is an anatomical scoring system that provides an overall score for patients with multiple injuries. Each injury is assigned an Abbreviated Injury Scale (AIS) score and is allocated to one of six body regions (Head, Face, Chest, Abdomen, Extremities (including Pelvis), External). Only the highest AIS score in each body region is used. The 3 most severely injured body regions have their score squared and added together to produce the ISS score.
The ISS score takes values from 0 to 75. If an injury is assigned an AIS of 6 (unsurvivable injury), the ISS score is automatically assigned to 75. The ISS score is virtually the only anatomical scoring system in use and correlates linearly with mortality, morbidity, hospital stay and other measures of severity.
The EZ-IO intraosseous system is an alternative to central venous access. It is capable of infusion rates of 7-9 liters/hour (116-150 ml/min).
Cold environment at the scene, during transport, in radiology, and in the ER.
Exposing the patient’s skin at the scene, in the ER and in the OR.
Cold operating room. The US Army suggest an operating room temperature of 110 degrees. I kid you not.
On going loss of warm blood/urine.
Evaporation of water from open cavities and owing to the patient’s humidification of dry ventilation gases.
Rapid infusions of cold crystalloids, blood, and blood products.
Coagulopathy (APTT greater than 60 seconds):
Loss of clotting factors from hemorrhage.
Dilution of clotting factor by infusion of crystalloid and packed red blood cells.
Inhibition of the clotting cascade by hypothermia.
Acidosis (pH less than 7.1):
Hypoperfusion due to hypovolemia.