Page 488 - Clinical Small Animal Internal Medicine

Box 46.1 Animal Trauma Triage Score (ATT)

Perfusion Penetration of abdomen/thorax. Abrasion/laceration 3
full thickness, deep tissue involved. Artery/nerve/
MM pink/moist CRT 2 s, T ≥100F, strong or bounding 0 muscle compromised
VetBooks.ir MM hyperemic OR pale pink, tacky, T ≥100F, CRT 1 Skeletal
femoral pulse quality
0–2 s, fair femoral pulses
MM very pale pink and tacky, CRT 2–3 s, T <100F, 2 Wt bearing 3 or 4 limbs. No palpable fx/jt laxity 0
detectable but poor pulses Closed limb fx/rib fx or any mandibular fx. Single jt 1
MM gray/blue/white, CRT >3 s, T <100F, no palpable 3 laxity/lux (including SI), pelvic fx with unilateral
femoral pulses intact SI‐ilium‐acetabulum. Single limb open/closed
fx at or below carpus/tarsus
Cardiac
Multiple grade 1 conditions, single long bone open fx 2
HR canine 60–140 bpm, feline 120–200 bpm, normal 0 above carpus/tarsus with cortical bone preserved.
sinus rhythm Nonmandibular skull fx
HR canine 140–180 bpm, feline 200–260 bpm, NSR or 1 Vertebral body fx/luxation except coccygeal, multiple 3
VPC <20/min long bone open fx above tarsus/carpus, single long
HR canine >180 bpm, feline >260 bpm, consistent 2 bone open fx above tarsus/carpus with loss of
arrhythmia cortical bone
HR canine <60 bpm, feline ≤120 bpm, erratic 3
arrhythmia Neurologic
Respiratory Central: consciousness: alert to sl dull. Periph: normal 0
spinal reflexes; purposeful movement and
Regular resp rate with no stridor, no abdominal 0 nociception in all limbs
component to resp Central: dull/depressed/withdrawn. Periph: abn. 1
Mild incr resp rate and effort, +/‐ abd comp, mild 1 spinal reflexes with purposeful movement and
upper airway sounds nociception intact in all 4 limbs
Mod incr resp rate and effort, some abd comp, elbow 2 Central: unconscious. Responds to noxious stimuli. 2
abduct, mod incr upper airway Periph: absent purposeful movement with intact
Marked resp effort OR gasping/agonal resp, little/no 3 nociception in 2 or more limbs OR nociception
air passage
absent in 1 limb. Decr anal or tail tone
Eye/muscle/integument Central: nonresponsive to all stimuli, refractory 3
seizures. Periph: absent nociception in 2 or more
Abrasion/laceration – none or partial thickness. Eye: 0 limbs; absent tail or perianal nociception
no fluorescein uptake
Abrasion/laceration – full thickness. NO deep tissue 1 Source: Adapted from Rockar et al. (1994).
involved. Eye: corneal lac, not perf
Abrasion/laceration – full thickness, deep tissue 2 CRT, capillary refill time; HR, heart rate; MM, mucous membranes;
NSR, normal sinus rhythm; SI, sacroiliac; VPC, ventricular premature
involved. Artery/nerve/muscle intact. Eye: corneal contraction.
perforation, punctured globe or proptosis

Box 46.2 Modified Glasgow Coma Score (MGCS)
Motor activity Unilateral, unresponsive mydriasis & reduced to 2
absent oculocephalic reflexes
Normal gait, normal spinal reflexes 6 Bilateral, unresponsive mydriasis & reduced to absent 1
Hemiparesis, tetraparesis, or decerebrate activity 5 oculocephalic reflexes
Recumbent, intermittent extensor rigidity 4
Recumbent, constant extensor rigidity 3 Level of consciousness
Recumbent, constant extensor rigidity with 2 Occasional periods of alertness and responsive to 6
opisthotonus environment
Recumbent, hypotonia of muscles, depressed or 1 Depression or delirium, responsive, but response may 5
absent spinal reflexes
be inappropriate
Brainstem reflexes Semicomatose, responsive to visual stimuli 4
Semicomatose, responsive to auditory stimuli 3
Normal pupillary light reflexes and oculocephalic reflexes 6 Semicomatose, responsive only to repeated noxious 2
Slow pupillary light reflexes and normal to reduced 5 stimuli
oculocephalic reflexes Comatose, unresponsive to repeated noxious stimuli 1
Bilateral unresponsive miosis with normal to reduced 4
oculocephalic reflexes Source: Adapted from Platt et al. (2001).
Pinpoint pupils with reduced to absent oculocephalic 3
reflexes