Orthopaedics & Trauma Emergency Medicine Anaesthesia / Critical Care Standard trauma scoring

Injury Severity Score (ISS)

Anatomical scoring of injury severity. Sum of squares of top 3 AIS scores from 6 body regions. Score >15 = major trauma.

Head / Neck (AIS)*

AIS: 0=none, 1=minor, 2=moderate, 3=serious, 4=severe, 5=critical, 6=unsurvivable

Face (AIS)*

Chest / Thorax (AIS)*

Abdomen / Pelvis (AIS)*

Extremities / Bony Pelvis (AIS)*

External (AIS)*

Skin, burns, degloving

Score interpretation

Minor Injury 0–8

ISS 0–8: Minor injury. Low mortality.

→ Standard management based on individual injuries.

Moderate Injury 9–15

ISS 9–15: Moderate injury. Increased risk of complications.

→ Inpatient admission. Serial observations. Trauma team review.

Serious Injury 16–24

ISS 16–24: Serious injury. Major trauma threshold (>15). Significant mortality risk.

→ Major trauma centre if available. Trauma team activation. Early CT pan-scan. Damage control surgery principles.

Severe / Critical Injury 25–74

ISS 25–74: Severe to critical injury. High mortality.

→ Major trauma centre mandatory. ICU. Damage control resuscitation. Haemostatic resuscitation (1:1:1 pRBC:FFP:Plt).

Unsurvivable 75

ISS 75: AIS 6 in any region = automatically unsurvivable.

→ Palliative / comfort care. Family notification.

Interpretation bands for the ISS. Apply clinical judgement and local guidance.

Baker SP et al. The Injury Severity Score: a method for describing patients with multiple injuries. J Trauma. 1974.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.