The International Red Cross has developed a standard scoring system for describing war wounds. This can be applied quickly in combat conditions and can encompass multiple wounds.
Parameters:
(1) E = entry
(2) X = exit
(3) C = cavity
(4) F = fracture
(5) V = vital structure
(6) M = metallic body visible on X-ray
|
Parameter |
Finding |
Code for Each Wound |
|---|---|---|
|
entry wound (E) |
|
E |
|
exit wound (X) |
no exit wound |
X0 |
|
|
exit wound present |
X |
|
cavity (C) |
no wound cavity |
C0 |
|
|
wound with cavity |
C1 |
|
fracture (F) |
no fracture |
F0 |
|
|
simple fracture, hole or clinically insignificant comminution |
F1 |
|
|
fracture with significant comminution |
F2 |
|
vital structure (V) |
no vital structures injured |
V0 |
|
|
injury to viscera, major blood vessel, central nervous system |
V1 |
|
metallic body (M) |
no metallic body |
M0 |
|
|
1 metallic body |
M1 |
|
|
>= 2 metallic bodies |
M2 |
where:
• If the wounds from the bullet path cannot be identified specifically as entry and exit, then "?" is placed between the scores.
• A cavity is one in which 2 fingers can be placed before making an incision into the wound.
• Comminution indicates breaking up into small fragments (shattering).
• Major blood vessels are those proximal to and including the brachial and popliteal arteries.
• The use of plastic bullets or shrapnel would limit he usefulness of the M code.
|
E + X (add the 2 scores) |
C or F Codes |
Grade |
|---|---|---|
|
< 10 |
C0, F0, F1 |
1 |
|
< 10 |
C1 OR F2 |
2 |
|
>= 10 |
C1 OR F2 |
3 |
|
V Code |
F Code |
Type |
|---|---|---|
|
V0 |
F0 |
ST (soft tissue) |
|
V0 |
F1 or F2 |
F |
|
V1 |
F0 |
V |
|
V1 |
F1 or F2 |
VF |
Purpose: To describe a war wound using the EXCFVM coding system from the International Red Cross.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
Objective: severity, prognosis, stage, comorbid conditions, disability and performance, quality of life, psychological response
ICD-10: Y36,
