tash_score v.1
TASH Score helps in determining the need for massive transfusion in trauma patients with severe hemorrhage. The score is based on clinical signs and laboratory test results. This score therefore helps in reducing the risk of morbidity and mortality in trauma patients caused either by delaying the initiation of massive transfusion or by transfusing blood products unnecessarily.
The TASH score is obtained by adding up the scores of each of the 8 attributes; Sex, Hemoglobin, Base excess, Systolic blood pressure, Positive FAST (Focused Assessment with Sonography in Trauma) for Intra-Abdominal Fluid, Clinically Unstable Pelvic Fracture, Open or Dislocated Femur Fracture. The scores range from 0-31. Each score corresponds to the probability of need for massive transfusion.
TASH score is used to predict when to initiate the massive transfusion protocol for a severely injured patient with massive hemorrhage. It is based on 8 attributes which includes both clinical assessment and laboratory tests. Massive transfusion protocols are institution-specific, but often are 1:1:1 or 1:1:2 for fresh frozen plasma, platelets, and packed red blood cells. Variables Points Sex Female 0 Male 1 Hemoglobin >=12g/dl 0 <12g/dl 2 < 11g/dl 3 < 10g/dl 4 <9g/dl 6 <7g/dl 8 Base excess >= - 2 mmol/L 0 < -2mmol/L 1 < - 6 mmol/L 3 < - 10 mmol/l 4 Systolic BP >= 120 mmHg 0 < 120 mmHg 1 < 100 mmHg 4 Heart Rate <=120 bpm 0 > 120 bpm 2 Positive FAST for No 0 Intra-Abdominal Yes 3 Fluid Clinically Unstable No 0 Pelvic Fracture Yes 6 Open or Dislocated No 0 Femur Fracture Yes 3 Interpretation of score: This interpretation of the score is according to the study by Maegele et al., 2011, revalidating and updating the TASH Score. TASH Score Probability for massive transfusion 1 - 8 < 5% 9 6% 10 8% 11 11% 12 14% 13 18% 14 23% 15 29% 16 35% 17 43% 18 50% 19 57% 20 65% 21 71% 22 77% 23 82% >24 > 85%
The TASH Score is strictly for determining when to initiate Massive Transfusions. It must not be used for determining other blood transfusions.
1. Yücel N, Lefering R, Maegele M, Vorweg M, Tjardes T, Ruchholtz S, et al. Trauma Associated Severe Hemorrhage (TASH)-Score: Probability of Mass Transfusion as Surrogate for Life Threatening Hemorrhage after Multiple Trauma. Journal of Trauma and Acute Care Surgery. 2006 Jun;60(6):1228–1237.
openEHR-EHR-OBSERVATION.tash, openEHR-EHR-EVALUATION.tash_assessment
