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Origins of AIS ( 3 ) - ✔✔ 1 ) Standardized system 2 ) Classify type/severity of injury from MVC 3 ) Consensus Injury descriptors are organized? - ✔✔Anatomically Injury severity is ranked relative to its importance to _? - ✔✔The whole body AIS reflects severity of single injuries and are unaffected by what three things? - ✔✔ 1 ) time 2 ) sequela 3 ) outcome What type of scale does AIS use? - ✔✔ 6 point ordinal scale Which type of measurement is more variable? Anatomic or Physiologic? - ✔✔Physiologic Is clinical training necessary for collecting injury data? - ✔✔NO AIS is based on what three ( 3 ) factors? - ✔✔ 1 ) anatomically- based 2 ) consensus driven 3 ) global Severity is NOT contingent upon what two ( 2 ) factors? - ✔✔
1 ) Outcome 2 ) time Numerical ranking of severity: 1 - ✔✔minor Numerical ranking of severity: 2 - ✔✔moderate Numerical ranking of severity: 3 - ✔✔serious Numerical ranking of severity: 4 - ✔✔severe Numerical ranking of severity: 5 - ✔✔critical Numerical ranking of severity: 6 - ✔✔maximum (currently untreatable) Is mortality a sole determinant of AIS severity? - ✔✔NO Are all AIS data comparable from year to year? - ✔✔NO (updates) Is "DEATH" part of the severity scale? - ✔✔NO Is a patient who dies automatically assigned the highest AIS severity of 6? - ✔✔NO (patients w/ minor injuries can die) Does a linear relationship exist between AIS severity codes? - ✔✔NO (AIS 4 is more, NOT twice as severe as AIS 2 ) Are all injuries within the same AIS code strictly compatible? - ✔✔NO (tibia fx & alveolar ridge are both AIS - 2 , although one may be worse than the other, both are considered 'moderate')
Brackets in the AIS dictionary indicate what? - ✔✔inclusionary/exclusionary info, OIS Grades Boxed bold type in the AIS dictionary indicates what? - ✔✔directions to help coder choose appropriate code Semicolons in the AIS dictionary indicate what? - ✔✔separate injury descriptors that are comparable in severity Italics in the AIS dictionary indicate what? - ✔✔proper-named injuries/structures, OIS grades Does AIS assess the severity of multiple injuries? - ✔✔NO (single injury severity only) The injury Severity Score (ISS) is defined as what? - ✔✔Sum of the squares of highest AIS in each of three most severely injured ISS body regions. What are the six body regions used in the ISS? - ✔✔ 1 ) head & neck 2 ) face 3 ) chest 4 ) abdomen & pelvic organs 5 ) extremities & pelvis 6 ) external Asphyxia is assigned to which ISS region? - ✔✔Head and Neck Drowning is assigned to which ISS region? - ✔✔Chest Lumbar spine lesions would be assigned to which ISS region? - ✔✔Abdomen & pelvic contents Are external injuries coded independent of their body region? - ✔✔YES
Hypothermia, electrical injuries, and whole body injuries are coded to which ISS region? - ✔✔External The ISS score ranged from to? - ✔✔ 1 to 75 What are the two ways an ISS of 75 can be achieved? - ✔✔ 1 ) AIS of 5 in each of three different body regions 2 ) AIS of 6 in a single body region Do patients with an AIS 9 achieve an accurate ISS score? - ✔✔NO Can less than three regions be used to calculate an ISS? - ✔✔YES Can more than three regions be used to calculate an ISS? - ✔✔NO Do all ISS scores have the same mortality rates? - ✔✔NO (depends on body regions affected) Assigning injuries to too few body regions results in what? - ✔✔underestimation of ISS Assigning injuries to too many body regions results in what? - ✔✔overestimation of ISS Are complications or sequela included in the definition of an injury? - ✔✔NO Define injury? - ✔✔Anatomic lesion resulting from transfer of injury. List seven ( 7 ) examples of sequela that are coded in AIS as injuries? - ✔✔ 1 ) HTX/PTX 2 ) retroperitoneal hemorrhage 3 ) cerebral edema/swelling 4 ) ischemic brain damage r/t head trauma 5 ) blood loss 6 ) asphyxia
Is death automatically coded as an AIS 6? - ✔✔NO Can an AIS of 1 result in death? - ✔✔YES (rare) Are cord lesions and vertebral fxs coded separately? - ✔✔NO What is important to look for when coding blunt trauma? - ✔✔associated/underlying injuries Penetrating injuries that do not injure underlying structures should be coded in what ISS body region? - ✔✔External Injuries that result from energy dissipated from a penetrating wound are called direct or indirect? - ✔✔indirect With penetrating injuries to internal structures, is the overlying skin injury coded separately? - ✔✔NO Bullet wounds/penetrating injuries resulting in fx are coded as open or closed fractures? - ✔✔OPEN When detailed information regarding an injury is lacking, what descriptor is often used? - ✔✔NFS NFS can refer to what two components of a code? - ✔✔ 1 ) injury unspecified 2 ) severity unspecified Should patients with AIS code 9 injuries be included in research studies? - ✔✔NO An articular fracture involves what structure? - ✔✔JOINT A fracture with three or more fragments with proximal and distal fragments not touching is defined as what? - ✔✔complex
When two ends of a bone are not aligned the fracture is called what? - ✔✔displaced When multiple bone fragments are present a fracture is called what? - ✔✔comminuted Sprains occur to joints or muscles? - ✔✔joints Strains occur to joints or muscles? - ✔✔muscles Massive destruction of a body part with damage to underlying skeletal, tissue, organ, and vascular systems is known as what type of injury? - ✔✔crush (T/F) A vessel puncture or perforation is also known as a laceration. - ✔✔TRUE (T/F) A muscle tear, rupture, or avulsion is also known as a laceration. - ✔✔TRUE Blood loss of > 20 % is approximately how many cc? - ✔✔> 1000 cc When there is any question about the severity of an injury based upon all available information the coder should chose the severe AIS code in that category. - ✔✔least Brain death/blindness are consequences of injury and can or cannot be coded? - ✔✔cannot Is a foreign body considered and injury in and of itself? - ✔✔NO (cannot code) (T/F) Bilateral injures of kidneys, eyes, ears, and extremities are typically codes as separate injuries (with some exceptions). - ✔✔TRUE (T/F) Multiple fractures to the same bone but in different areas are coded separately. - ✔✔TRUE (T/F) If multiple fractures to a single bone exist but are not specified as to location, they are coded as a single injury. - ✔✔TRUE
"GSW to abdomen" with no further description would be coded to External or Abdominal ISS body region? - ✔✔Abdominal If a single penetrating injury to the brain involves more than one structure (entry to cerebrum, exit cerebellum) do you code each region separately? - ✔✔NO (use whole area section) (T/F) When a penetrating injury exists, and using the penetrating code results in a higher AIS than using subsequent qualifiers, the higher AIS penetrating code should be used. - ✔✔True Vague descriptions such as "blunt trauma" or "closed head injury" should be assigned which AIS code? - ✔✔ 9 When assigning severity codes, the coder should use the physicians description of the injury or the AIS definition? - ✔✔AIS definition If the physicians OIS grading differs from the AIS definition of the injury, which should be used for coding? - ✔✔AIS definition If no description is available for a solid organ injury other than the OIS grade, is it acceptable to use this information for assigning an AIS code? - ✔✔YES (T/F) In order to assign an AIS code with "blood loss > 20 %" you must know to what area of the body the blood loss is linked. - ✔✔TRUE Are dimensions of lesions used to determine injury severity? - ✔✔YES In an adult, 100 % blood volume is considered approximately how many cc? - ✔✔ 5000 cc (T/F) The severity of codes in AIS are NOT age adjusted in some categories. - ✔✔FALSE Fractures may be best described in what type of report? - ✔✔radiology
Organ injuries may best be described in what type of report? - ✔✔operative Can patient or bystander reports of LOC be used for coding purposes? - ✔✔NO Which type of report is highest on the ranking of most reliable sources of injury information? - ✔✔M.E./Autopsy reports List the eight ( 8 ) types of hospital/medical record reports from highest to lowest rank in reliability of injury information. - ✔✔ 1 ) Autopsy 2 ) Operative 3 ) Radiology 4 ) Nursing/ICU 5 ) MD progress notes 6 ) ED record 7 ) D/C Summary 8 ) Face Sheet What is considered the least reliable source of injury information? - ✔✔patient List the seven ( 7 ) injury descriptions included in the ISS external body region? - ✔✔ 1 ) abrasion 2 ) contusion 3 ) laceration 4 ) avulsion 5 ) degloving 6 ) penetrating 7 ) burn A rubbed or scraped area on skin or mucous membranes caused by contact with a rough surface that removes layers is known as what? - ✔✔abrasion
1 st degree burn is described as _? - ✔✔superficial 2 nd degree burn is described as? - ✔✔partial thickness 3 rd degree burn is described as _? - ✔✔full thickness Is age adjustment required for burns? - ✔✔YES When burns are only described as combined degrees, the coder should choose the least or most severe code? - ✔✔most severe When burns occur in varying degrees, which type of burns are coded separately from the others? - ✔✔ 1 st degree When either 2 nd and/or 3 rd degree burns are < 10 % TBSA, should the 2 nd and 3 rd degree burns be coded separately or combined? - ✔✔separately If 2nd and 3 rd degree burns combined are > 10 % TBSA, they should be coded separately or combined? - ✔✔combined Burn amputations should be coded to which ISS body region? - ✔✔specific to body part Are burns coded separately from burn amputations they cause? - ✔✔NO If an electrical injury causes a "flash" burn, should the burn injury be coded separately? - ✔✔NO Frostbite is assigned to which ISS body region? - ✔✔external Asphyxia/suffocation is assigned to which ISS body region? - ✔✔Head Caustic agent inhalation injuries are assigned to which ISS body region? - ✔✔Chest
Caustic agent ingestion injuries are coded to which ISS body region? - ✔✔specific organ injured Drowning is assigned to which ISS body region? - ✔✔Chest Hypothermia is coded to which ISS body region? - ✔✔External Whole body blast injuries are assigned an AIS code of and are coded to which ISS body region? - ✔✔6;External List the five ( 5 ) body parts coded in the AIS face body region. - ✔✔ 1 ) eyes 2 ) ears 3 ) nose 4 ) mouth 5 ) facial bones What is the only vessel included in the Face AIS body region? - ✔✔external carotid (and its branches, facial/internal maxillary) What is the only nerve included in the Face AIS body region? - ✔✔optic (intraorbital) A compound fracture is considered open or closed? - ✔✔open A simple fracture is considered open or closed? - ✔✔closed The face is divided into how many sections for coding purposes? - ✔✔three A transverse horizontal maxillary alveolar fracture, or palate facial disjunction (Guerin) is known as what type of LeFort Fx? - ✔✔LeFort I
Below what anatomic landmark are the trachea and esophagus coded to the chest ISS region? - ✔✔sternal notch Which portion of the aorta is coded to the chest ISS region? - ✔✔thoracic The larynx/vocal cords are coded to which ISS body region? - ✔✔Head/Neck The shoulders are coded to which ISS body region? - ✔✔extremities/pelvic girdle (T/F) A "crush" injury to the thoracic region must be bilateral in nature? - ✔✔TRUE A "sucking" wound of the chest indicates that it is open or closed? - ✔✔open What membrane lines the chest wall? - ✔✔Parietal pleura What membrane lines the organ? - ✔✔visceral PTX/HTX fills what cavity in the chest? - ✔✔intrapleural space Is the rib cage considered a single anatomic structure for coding purposes? - ✔✔YES If you have unilateral flail chest with rib fxs to the opposite side are the injuries coded combined or separate? - ✔✔separate Unilateral rib fxs with same sided unilateral flail chest are coded combined or separate? - ✔✔combined Three or more ribs fractured in two or more places defines what injury? - ✔✔flail chest Do multiple rib fxs NFS have a specific AIS code? - ✔✔YES
A costal cartilage tear or fracture is coded as what type of injury? - ✔✔rib fx Are "clinical rib fxs" coded? - ✔✔NO (must have radiology/OR/autopsy) Can lung contusions be coded on the bases of pulmonary dysfunction alone? - ✔✔NO (T/F) Rib fractures with underlying injuries such as a lung contusion or laceration should be coded as one single injury combined. - ✔✔FALSE Injestion injuries in the chest are coded to which organ? - ✔✔esophagus (T/F) Air embolus and tamponade are codeable sequela in the chest ISS region. - ✔✔TRUE "Blast" and inhalation injuries in the chest are coded to which organ? - ✔✔lungs What should be used when a specific artery or vein is not named in the AIS description but is injured? - ✔✔other named "Incomplete transection" vessel injuries are coded as what in AIS? - ✔✔incomplete circumferential involvement What two ISS body regions may the aorta and vena cava be coded under depending on the location of their injury? - ✔✔chest abdomen The lumbar spinal cord and lumbar vertebrae are assigned to which ISS body region? - ✔✔abdomen Avulsion, complex, rupture, tissue loss, and deep are all synonyms for what severity of organ injury? - ✔✔massive What type of organ injury involves the ripping away of an organ from its vascular attachment? - ✔✔avulsion
(T/F) Abdominal compartment syndrome is a sequela of abdominal trauma and is therefore NOT coded. - ✔✔TRUE When only one ductal injury is occurs, it should be assigned to EITHER, or BOTH of the associated organs? - ✔✔either Injuries to the shoulders, hip, buttocks, and pelvic girdle are assigned to which ISS body region? - ✔✔extremities and pelvic girdle Shoulder joint injuries such as acromioclavicular and sternoclavicular are assigned to which ISS body region? - ✔✔extremities and pelvic girdle (T/F) Pelvic bones are coded to the abdominal ISS body region. - ✔✔FALSE Nerve palsy is synonymous with what type of injury? - ✔✔contusion Sprains refer to the tearing of what type of tissue? - ✔✔ligament Strains refer to the tearing of what type of tissue? - ✔✔tendon (T/F) Closed and NFS fractures share the same 7 digit AIS numerical identifier. - ✔✔TRUE Partial separation of a joint, or partial dislocation is known as what type of injury? - ✔✔subluxation Complete separation of a joint is known as what type of injury? - ✔✔dislocation The overall severity of pelvic fractures is related to or _. - ✔✔stability instability Penetrating injuries to bones and tissues are coded as what type of fractures to the specific bone? - ✔✔open
(T/F) Thumb and non-thumb fingers are separate injury categories. - ✔✔TRUE Are degloving injuries to extremities coded to the extremity or external ISS body region? - ✔✔external Does fracture displacement affect the severity of an injury for AIS coding purposes? - ✔✔NO What are the two anatomic structures of the pelvis for AIS coding purposes? - ✔✔ 1 ) pelvic ring 2 ) acetabulum (T/F) Bilateral acetabulum fractures are coded separately. - ✔✔TRUE (T/F) Bilateral pelvic ring structures are coded separately. - ✔✔FALSE The severity of a pelvic fracture is related to the extent of damage to which arch, anterior or posterior? - ✔✔posterior How many columns are contained within the acetabulum? - ✔✔two (T/F) A partial articular acetabulum fracture may involve one or both columns? - ✔✔TRUE For a complete articular acetabulum fracture to exist, separation of the attachment between the articular surface and the posterior must occur. - ✔✔ilium Bilateral proximal amputations are coded combined or separate? - ✔✔combined Level of pelvic instability is determined by extent of damage to which two portions of the pelvis? - ✔✔ 1 ) posterior ligaments 2 ) pelvic floor
