Nelson Score for Trauma

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Contemplate this quick screening tool to determine the appropriate service for patients who present with ground-level fall (GLF). 

American College of Surgeons 2022 Standards performance improvement and patient safety (PIPS) audit filter 7.8 states:

“In all trauma centers, all nonsurgical trauma admissions must be reviewed by the trauma program. Nonsurgical admissions (NSA) without trauma or other surgical consultation, with Injury Severity Score (ISS) > 9, or with identified opportunities for improvement must, at a minimum, be reviewed by the Trauma Medical Doctor (TMD) in secondary review.”

Criteria Points
Age >65 years 1
3 or more comorbidities 1
ISS <10 1
Ground level fall (GLF) 1
No ICU admission 1
No need for surgical intervention 1
No blood products given 1


Scoring Criteria
<4 points Inappropriate non-surgical admit
4-5 points Further review
6-7 points Appropriate non-surgical admit

American College of Surgeons 2022 Standards PIPS 7.2 measures of compliance list that the performance improvement (PI) audit filter includes “All nonsurgical admissions (excludes isolated hip fractures)” in its list of 29 audit filters to track.

Download the complete tip, Nelson Score for Trauma.