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Overview :
The CRAMS Scale
(Circulation, Respiration, Abdomen, Motor, Speech) measures 5 components and is
intended to triage those patients requiring transport to a trauma center. It is
intended to reduce the number of minor trauma cases referred to trauma
centers.
Parameters:
(1) systolic
blood pressure or capillary refill
(2)
respirations
(3) examination
of trunk
(4)
motor
(5)
speech
|
Parameter |
Finding |
Points |
|
systolic
blood pressure or capillary refill |
blood
pressure > 100 mm Hg, or normal capillary
refill |
2 |
|
|
85 <=
blood pressure <= 100 mm Hg, or delayed capillary
refill |
1 |
|
|
blood
pressure <85 mm Hg, or no capillary refill |
0 |
|
respirations |
normal |
2 |
|
|
abnormal
(labored and/or shallow) |
1 |
|
|
absent |
0 |
|
trunk |
thorax and
abdomen nontender |
2 |
|
|
thorax or
abdomen tender |
1 |
|
|
rigid
abdomen, flail chest, penetrating wound to chest, or penetrating wound to
abdomen |
0 |
|
motor |
normal |
2 |
|
|
responds
only to pain |
1 |
|
|
no
response or decerebrate |
0 |
|
speech |
normal |
2 |
|
|
confused |
1 |
|
|
no
intelligible words |
0 |
CRAMS scale
=
= (points for
systolic blood pressure or capillary refill) + (points for respirations) +
(points for trunk findings) + (points for motor response) + (points for
speech)
Interpretation:
• maximum score
(indicating least affected) : 10
• minimum score
(indicating most affected) : 0
• score <= 8: major trauma (those who
died in ED or who required emergency surgery)
• score >= 9:
minor trauma
| References: | |
Clemmer TP, Orme JF Jr, et al.
Prospective evaluation of the CRAMS scale for triaging major trauma. J Trauma.
1985; 25: 188-191.
Emerman CL, Shade B, Kubincanek J. A
comparison of EMT judgment and prehospital trauma triage instruments. J Trauma.
1991; 31: 1369-1375.
Emerman CL, Shade B, Kubincanek J.
Comparative performance of the Baxt Trauma Triage Rule. Am J Emerg Med. 1992;
10: 294-297.
Gormican SP. CRAMS Scale: Field triage of
trauma victims. Ann Emerg Med.
1982; 11: 132-135.
Koehler
JJ, Baer LJ, et al. Prehospital Index: A scoring system for
field triage of trauma victims. Ann Emerg Med. 1986; 15:
178-182.
Ornato J, Minek EJ Jr, et al.
Ineffectivenesss of the trauma score and the CRAMS scale for accurately triaging
patients to trauma centers. Ann Emerg Med. 1985; 14:
1061-1064.
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