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Overview :
The SIMBOL
rating system was designed for assessing trauma patients prior to air
evacuation. It consists of a status and predictor score. The status score
indicates the present clinical condition for the patient, while the predictor
score estimates the potential for recovery.
Status Score
Examination for
Status Score:
(1) pupillary
size and reaction to light
(2)
pulse
(3) respiratory
rate
(4) palpable
systolic blood pressure, or skin color
(5) level of
consciousness
|
Sign |
Finding |
Points |
|
pupils |
small and
responsive to light |
2 |
|
|
unequal to
sluggish |
1 |
|
|
dilated
and fixed |
0 |
|
pulse |
60 - 100
beats/minute |
2 |
|
|
< 60 or
> 100 |
1 |
|
|
absent |
0 |
|
respiration |
10 - 20
breaths/minute |
2 |
|
|
< 10 or
> 20 |
1 |
|
|
absent |
0 |
|
blood
pressure, palpable systolic |
more than
100 |
2 |
|
|
60
-100 |
1 |
|
|
<
60 |
0 |
|
skin |
dry and
normal color |
2 |
|
|
ashen,
blue lips, moist |
1 |
|
|
waxy,
colorless, or mottled |
0 |
|
level of
consciousness |
awake and
coherent |
2 |
|
|
difficult
to awake, sleepy |
1 |
|
|
totally
unresponsive |
0 |
status score
=
= (points for
pupils) + (points for pulse)+ (points for respiration)+ [OR (points for blood
pressure), (points for skin)] + (points for level of
consciousness)
Interpretation:
• maximum score:
10, which indicates a good clinical condition
• minimum score:
0, which indicates a moribund condition
Predictor Score
Evaluation for
Predictor Score
(1) status score
(above)
(2) body
weight
(3)
age
(4) nature of
traumatic injury
|
Predictor |
Finding |
Points |
|
body
weight |
not
morbidly obese |
0 |
|
|
morbidly
obese |
1 |
|
age in
years |
< 2
years of age |
1 |
|
|
2 – 70
years of age |
0 |
|
|
> 70
years of age |
1 |
|
burn
injury |
none |
0 |
|
|
<=
50% |
0 |
|
|
>
50% |
1 |
|
chest or
abdominal wounds |
no open
chest or abdominal wounds |
0 |
|
|
open chest
or abdominal wound |
1 |
|
consciousness |
unconscious |
1 |
|
|
conscious
and able to move fingers and toes |
0 |
|
|
conscious
but unable to move fingers and toes |
1 |
total number of
predictors =
= SUM(points for
all of the parameters present)
predictor value
=
= (status score)
- (sum of predictors)
Interpretation:
• The higher the
predictor value, the more favorable the prognosis.
• A low predictor number indicates a rate
of change consistent with a poorer prognosis.
| References: | |
Committee on Medical Aspects of
Automotive Safety. Rating the severity of tissue damage: I. The abbreviated
scale. JAMA. 1971; 215: 277-280.
Williams RE, Schamadan JL. The "Simbol"
rating and evaluation system. Arizona Med. 1969; 26:
886-887.
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