Gormican S P
Ann Emerg Med. 1982 Mar;11(3):132-5. doi: 10.1016/s0196-0644(82)80237-0.
A simple 10-point scale was devised for the purpose of determining which trauma patients should go to a trauma center. The acronym "CRAMS" represents the five components measured: Circulation, Respiration, Abdomen, Motor, and Speech. The results of field triage were compared to final emergency department (ED) disposition. Those patients who died in the ED and those who went directly to the operating room (OR) for general surgery or neurosurgery were defined as major trauma. Of 12 patients defined as major trauma by ED disposition, 11 were defined as major trauma (CRAMS less than or equal to 8) in the field (sensitivity, 92%). This was compared to 8 defined as major trauma by Champion's Trauma Score. Of 313 defined as minor trauma by ED disposition (discharged home), 307 were defined as minor trauma (CRAMS greater than or equal to 9) in the field (specificity, 98%). The CRAMS scale provides an effective net for major trauma while ensuring that minor trauma is not unnecessarily diverted to a trauma center.
为确定哪些创伤患者应前往创伤中心，设计了一个简单的10分制量表。首字母缩写词“CRAMS”代表所测量的五个组成部分：循环、呼吸、腹部、运动和言语。将现场分诊结果与急诊科最终处置情况进行比较。那些在急诊科死亡的患者以及那些直接前往手术室进行普通外科手术或神经外科手术的患者被定义为严重创伤。在急诊科处置中被定义为严重创伤的12例患者中，11例在现场被定义为严重创伤（CRAMS评分小于或等于8）（敏感性为92%）。相比之下，根据冠军创伤评分，有8例被定义为严重创伤。在急诊科处置中被定义为轻伤（出院回家）的313例患者中，307例在现场被定义为轻伤（CRAMS评分大于或等于9）（特异性为98%）。CRAMS量表为严重创伤提供了一个有效的筛选工具，同时确保轻伤患者不会被不必要地转送至创伤中心。
