The Illness/Injury Severity Index is a triage tool which can be used to recommend patient disposition after assessing the severity of traumatic injury.
Parameters:
(1) pulse
(2) blood pressure
(3) skin color
(4) respiratory condition
(5) consciousness
(6) bleeding
(7) region of injury
(8) type of injury
(9) age of patient
(10) previous history of condition
|
Parameter |
Finding |
Points |
|
pulse |
60 - 100 |
0 |
|
|
< 60, or 100 - 140 |
1 |
|
|
> 140 or irregular |
2 |
|
|
absent |
3 |
|
blood pressure in mm Hg |
systolic 100 - 150; diastolic 60 - 90 |
0 |
|
|
systolic 80 - 100 or 150 - 200; diastolic 90 - 120 |
1 |
|
|
systolic < 80 or > 200; diastolic > 120 |
2 |
|
|
absent |
3 |
|
skin color |
dry and normal |
0 |
|
|
reddish coloration |
1 |
|
|
ashen and/or moist |
2 |
|
|
cyanotic |
3 |
|
respiratory condition |
12 - 20 breaths per minute |
0 |
|
|
>= 20 breaths per minute |
1 |
|
|
< 12 breaths per minute, or labored breathing or chest pain |
2 |
|
|
absent respirations |
3 |
|
consciousness |
alert and oriented |
0 |
|
|
incoherent or obtunded |
1 |
|
|
difficult to awaken |
2 |
|
|
unconscious |
3 |
|
bleeding |
none |
0 |
|
|
controllable |
1 |
|
|
hard to control |
2 |
|
|
uncontrollable |
3 |
|
region of injury |
none observed |
0 |
|
|
extremities |
1 |
|
|
back |
2 |
|
|
chest |
3 |
|
|
head, neck, abdomen |
4 |
|
type of injury |
none observed |
0 |
|
|
laceration or contusion |
1 |
|
|
fracture |
2 |
|
|
stab wound |
3 |
|
|
blunt trauma or missile |
4 |
|
age |
< 2 years of age |
1 |
|
|
2 - 60 years of age |
0 |
|
|
> 60 years of age |
1 |
|
previous history of condition being treated |
no |
0 |
|
|
yes |
1 |
where:
• The scoring of systolic and diastolic blood pressure is unclear; it is presented as a ratio, could be ANDed, but implemented as OR
• The above table differs from the table in Bever and Veenker with the addition of "none" for both region of injury and type of injury. This is explained in the text on page 45.
• Age and previous history are listed as footnotes in the original table.
illness/injury severity index =
= (points for pulse) + (points for blood pressure) + (points for skin color) + (points for respiratory condition) + (points for consciousness) + (points for bleeding) + (points for region of injury) + (points for type of injury) + (points for age) + (points for previous history)
Interpretation:
• minimum index: 0
• maximum index: 28
|
Index |
Outcome in Illness Group |
|
<= 3 |
patients can be released from the Emergency Department |
|
4 - 6 |
patient admitted to hospital but non-critical care unit |
|
7 - 11 |
patient admitted to critical care unit or had surgery |
|
>= 12 |
predicts patient death in the emergency department |
