The SIMBOL rating system was designed for assessing trauma patients prior to air evacuation. It consists of a status and predictor score. The status score indicates the present clinical condition for the patient, while the predictor score estimates the potential for recovery.
Status Score
Examination for Status Score:
(1) pupillary size and reaction to light
(2) pulse
(3) respiratory rate
(4) palpable systolic blood pressure, or skin color
(5) level of consciousness
|
Sign |
Finding |
Points |
|---|---|---|
|
pupils |
small and responsive to light |
2 |
|
|
unequal to sluggish |
1 |
|
|
dilated and fixed |
0 |
|
pulse |
60 - 100 beats/minute |
2 |
|
|
< 60 or > 100 |
1 |
|
|
absent |
0 |
|
respiration |
10 - 20 breaths/minute |
2 |
|
|
< 10 or > 20 |
1 |
|
|
absent |
0 |
|
blood pressure, palpable systolic |
more than 100 |
2 |
|
|
60 -100 |
1 |
|
|
< 60 |
0 |
|
skin |
dry and normal color |
2 |
|
|
ashen, blue lips, moist |
1 |
|
|
waxy, colorless, or mottled |
0 |
|
level of consciousness |
awake and coherent |
2 |
|
|
difficult to awake, sleepy |
1 |
|
|
totally unresponsive |
0 |
status score =
= (points for pupils) + (points for pulse)+ (points for respiration)+ [OR (points for blood pressure), (points for skin)] + (points for level of consciousness)
Interpretation:
• maximum score: 10, which indicates a good clinical condition
• minimum score: 0, which indicates a moribund condition
Predictor Score
Evaluation for Predictor Score
(1) status score (above)
(2) body weight
(3) age
(4) nature of traumatic injury
|
Predictor |
Finding |
Points |
|---|---|---|
|
body weight |
not morbidly obese |
0 |
|
|
morbidly obese |
1 |
|
age in years |
< 2 years of age |
1 |
|
|
2 – 70 years of age |
0 |
|
|
> 70 years of age |
1 |
|
burn injury |
none |
0 |
|
|
<= 50% |
0 |
|
|
> 50% |
1 |
|
chest or abdominal wounds |
no open chest or abdominal wounds |
0 |
|
|
open chest or abdominal wound |
1 |
|
consciousness |
unconscious |
1 |
|
|
conscious and able to move fingers and toes |
0 |
|
|
conscious but unable to move fingers and toes |
1 |
total number of predictors =
= SUM(points for all of the parameters present)
predictor value =
= (status score) - (sum of predictors)
Interpretation:
• The higher the predictor value, the more favorable the prognosis.
• A low predictor number indicates a rate of change consistent with a poorer prognosis.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
ICD-10: ,
