Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm





    Chief Complaint


    Organ System


    Patent Pending

    Pediatric Trauma BIG Score

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


    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
    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.


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    Next Steps
    Creator Insights


    BIG Score alone should not direct clinical care because patients with BIG Scores <16 still require intensive care and trauma surgery services and should receive care at level 1 pediatric trauma centers (Davis 2015).


    Management of pediatric trauma patients depends on injuries diagnosed.

    Content Contributors
    • Jennie Kim, MD
    Reviewed By
    • Travis Polk, MD, FACS
    About the Creator
    Dr. Matthew A. Borgman
    Are you Dr. Matthew A. Borgman?
    Content Contributors
    • Jennie Kim, MD
    Reviewed By
    • Travis Polk, MD, FACS