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    Patent Pending

    Abbreviated Injury Score (AIS) for Inhalation Injury

    Classifies inhalation injury severity based on bronchoscopic findings.

    INSTRUCTIONS

    Use in adult patients with suspected inhalation injury undergoing flexible bronchoscopy.

    When to Use
    Pearls/Pitfalls
    Why Use

    Adult patients with suspected inhalation injury undergoing flexible bronchoscopy.

    • May predict development of ARDS, length of time on mechanical ventilation, and prolonged ICU stay.
    • Some studies have found a non-statistically significant trend towards worse outcomes with higher AIS.
    • AIS severity has not been consistently associated with mortality (Sheridan 2016).
    • Cannot reliably predict need for high fluid resuscitation requirements.
    • A typical flexible bronchoscope is on average 5 mm in diameter. Hence, bronchoscopy can only identify proximal airway changes and not the narrower distal and peripheral airway changes. Thus, bronchoscopic findings cannot be fully relied upon to accurately reflect the overall severity of airway inhalation injury.
    • No universal consensus exists on grading for inhalation injury. The AIS has been widely utilized as the predominant bronchoscopic inhalation injury severity score in the literature (but have not been compared head to head with other bronchoscopic criteria).
    • Of note, a multicenter prospective cohort study by the American Burn Association is currently underway to develop and validate a scoring system for inhalation injury based on clinical, radiographic, bronchoscopic, and biochemical parameters.
    No carbonaceous deposits, erythema, edema, bronchorrhea, or obstruction
    Minor or patchy areas of erythema, carbonaceous deposits, bronchorrhea, or bronchial obstruction present
    Moderate erythema, carbonaceous deposits, bronchorrhea, or bronchial obstruction present
    Severe inflammation with friability, copious carbonaceous deposits, bronchorrhea, or obstruction present
    Mucosal sloughing, necrosis, or endoluminal obstruction present

    Result:

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    Creator Insights
    Dr. Frederick W. Endorf

    About the Creator

    Frederick W. Endorf, MD, is a general surgeon affiliated with Hennepin County Medical Center in Minneapolis and the American Burn Association. His research interests include burns, trauma, and reconstructive surgery.

    To view Dr. Frederick W. Endorf's publications, visit PubMed

    Are you Dr. Frederick W. Endorf? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Dr. Richard L. Gamelli

    About the Creator

    Richard L. Gamelli, MD, FACS, is professor emeritus at the Stritch School of Medicine at Loyola University Chicago. He has served as the director of the Burn and Shock Trauma Research Institute, chairman of the department of surgery, and chief of the burn center at Loyola University Medical Center. Dr. Gamelli has published over 175 peer-reviewed manuscripts and abstracts, written 30 book chapters, and edited 10 books.

    To view Dr. Richard L. Gamelli's publications, visit PubMed

    Are you Dr. Richard L. Gamelli? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Pujan H. Patel, MD
    About the Creator
    Dr. Frederick W. Endorf
    Are you Dr. Frederick W. Endorf?
    Dr. Richard L. Gamelli
    Are you Dr. Richard L. Gamelli?
    Partner Content
    Content Contributors
    • Pujan H. Patel, MD