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Recommended reading

Boffard K.D., ed. Manual of definitive surgical trauma care, 3rd ed, London: Hodder Arnold, 2011.

Committee on Trauma of the American College of Surgeons.
Resources for optimal care of the trauma patient
. Chicago, IL: Committee on Trauma of the American College of Surgeons; 2006.

Peitzman A., Rhodes M., Schwab C.W., eds. The trauma manual: Trauma and acute care surgery. Philadelphia, PA: Lippincott, Williams & Wilkins, 2008.

Websites

Organ Injury Scaling of the American Association for the Surgery of Trauma.

www.aast.org

Eastern Association for the Surgery of Trauma.

Practice Management Guidelines.

www.east.org

World Society of the Abdominal Compartment Syndrome (WSACS).

www.wsacs.org

Appendix: Scaling system for organ-specific injuries

Scaling system for organ-specific injuries

Table A1
Cervical vascular organ injury scale
Table A2
Chest wall injury scale
Table A3
Heart injury scale
Table A4
Lung injury scale
Table A5
Thoracic vascular injury scale
Table A6
Diaphragm injury scale
Table A7
Spleen injury scale
Table A8
Liver injury scale
Table A9
Extrahepatic biliary tree injury scale
Table A10
Pancreas injury scale
Table A11
Oesophagus injury scale
Table A12
Stomach injury scale
Table A13
Duodenum injury scale
Table A14
Small-bowel injury scale
Table A15
Colon injury scale
Table A16
Rectum injury scale
Table A17
Abdominal vascular injury scale
Table A18
Adrenal organ injury scale
Table A19
Kidney injury scale
Table A20
Ureter injury scale
Table A21
Bladder injury scale
Table A22
Urethra injury scale
Table A23
Uterus (non-pregnant) injury scale
Table A24
Uterus (pregnant) injury scale
Table A25
Fallopian tube injury scale
Table A26
Ovary injury scale
Table A27
Vagina injury scale
Table A28
Vulva injury scale
Table A29
Testis injury scale
Table A30
Scrotum injury scale
Table A31
Penis injury scale
Table A32
Peripheral vascular organ injury scale

Table A1

Cervical vascular organ injury scale

*
Increase one grade for multiple grade III or IV injuries involving more than 50% vessel circumference. Decrease one grade for less than 25% vessel circumference disruption for grade IV or V.

Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling VII: Cervical vascular, peripheral vascular, adrenal, penis, testis and scrotum. J Trauma 1996; 41(3):523–4. With permission from Lippincott, Williams & Wilkins.

Table A2

Chest wall injury scale

*
This scale is confined to the chest wall alone and does not reflect associated internal or abdominal injuries. Therefore, further delineation of upper versus lower or anterior versus posterior chest wall was not considered, and a grade VI was not warranted. Specifically, thoracic crush was not used as a descriptive term; instead, the geography and extent of fractures and soft tissue injury were used to define the grade. Upgrade by one grade for bilateral injuries.

Reproduced from Moore EE, Cogbill TH, Jurkovich GJ. Organ Injury Scaling III: chest wall, abdominal vascular, ureter, bladder and urethra. J Trauma 1992; 33:337–8. With permission from Lippincott, Williams & Wilkins.

Table A3

Heart injury scale

*
Advance one grade for multiple wounds to a single chamber or multiple chamber involvement.

Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.

Table A4

Lung injury scale

*
Advance one grade for bilateral injuries up to grade III. Haemothorax is scored under thoracic vascular injury scale.

Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.

Table A5

Thoracic vascular injury scale

*
Increase one grade for multiple grade III or IV injuries if more than 50% circumference. Decrease one grade for grade IV injuries if less than 25% circumference.

Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.

Table A6

Diaphragm injury scale

*
Advance one grade for bilateral injuries up to grade III.

Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.

Table A7

Spleen injury scale (1994 revision)

*
Advance one grade for multiple injuries up to grade III.

Reproduced from Moore EE, Cogbill TH, Jurkovich GJ et al. Organ Injury Scaling: spleen and liver (1994 revision). J Trauma 1995; 38(3):323–4. With permission from Lippincott, Williams & Wilkins.

Table A8

Liver injury scale (1994 revision)

*
Advance one grade for multiple injuries up to grade III.

Reproduced from Moore EE, Cogbill TH, Jurkovich GJ et al. Organ Injury Scaling: spleen and liver (1994 revision). J Trauma 1995; 38(3):323–4. With permission from Lippincott, Williams & Wilkins.

Table A9

Extrahepatic biliary tree injury scale

*
Advance one grade for multiple injuries up to grade III.

Reproduced from Moore EE, Jurkovich GJ, Knudson MM et al. Organ Injury Scaling VI: extrahepatic biliary, oesophagus, stomach, vulva, vagina, uterus (non-pregnant), uterus (pregnant), Fallopian tube, and ovary. J Trauma 1995; 39(6):1069–70. With permission from Lippincott, Williams & Wilkins.

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