Audit and quality assurance
Injury severity scoring systems
Statistical analysis of injury severity and the most effective means of managing injured patients is relatively recent and is slowly replacing anecdote and unfounded assumptions. An example is the GCS, to which reference has already been made. The most widely applied is the Revised Trauma Score (RTS). Data combined from vital signs and level of consciousness are mathematically combined into a single variable that correlates with outcome. There is a myriad of others. Readers are referred to Professor Yates’ paper in the publication ABC of Major Trauma.
Major trauma outcome study (MTOS)
First developed in the USA, MTOS is an ongoing audit of the effectiveness of injury management and is now in widespread use in the UK. Utilising the TRISS (combination of the RTS and Injury Severity Score weighted for age and premorbidity) method with additional input on prehospital events, initial management including time to resuscitative interventions and the grading of medical staff, MTOS is applied to patients with severe injury and to those who die or are transferred to specialist units.
Benefits of MTOS
• Measures injury severity
• Records management and outcome
• Provides a database for audit
• Allows comparison of performance
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