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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Pediatric Trauma BIG Score

    Stratifies severity of illness and predicts mortality in pediatric patients after trauma.

    INSTRUCTIONS

    Use on admission in pediatric patients <18 years old who have sustained blunt or penetrating trauma or penetrating blast injury. Use lab values obtained on admission.

    When to Use
    Pearls/Pitfalls
    Why Use

    Pediatric patients under 18 years of age, after blunt or penetrating trauma or penetrating blast injury.

    • BIG is an acronym for the components of the score: base deficit, INR, and GCS.
    • Initial analysis (Borgman 2011) had more penetrating trauma and penetrating blast injuries, compared with the excluded patients who had more blunt injuries and burns. These were accounted for in the external validation, however.
    • May facilitate communication regarding prognosis with families and during patient transfer (Davis 2015).
    • If point of care testing is used, INR and base deficit results can be obtained in ~2 minutes (Borgman 2015).
    • Simple, rapid, and accurate scoring system to evaluate the severity of illness and predict mortality in children.
    • Can be applied to both blunt and penetrating traumatic injuries.
    • Useful in quantifying degree of physiological derangement beyond clinical appearance and GCS alone. Base deficit and INR are physiologic measures of hypoperfusion and trauma-induced coagulopathy, respectively, and both play critical roles in trauma-related mortality.
    mEq/L
    points

    Diagnostic Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Matthew A. Borgman

    About the Creator

    Matthew A. Borgman, MD, is a pediatric critical care physician at the Brooke Army Medical Center, Fort Sam Houston. He was previously an assistant professor in the pediatrics department at the Uniformed Services University of the Health Sciences. Dr. Borgman's research interests include pediatric trauma and trauma resuscitation simulation.

    To view Dr. Matthew A. Borgman's publications, visit PubMed

    Are you Dr. Matthew A. Borgman? 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
    • Jennie Kim, MD
    About the Creator
    Dr. Matthew A. Borgman
    Are you Dr. Matthew A. Borgman?
    Content Contributors
    • Jennie Kim, MD