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      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

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    Patent Pending

    RADS (Radiologist’s Score) for Smoke Inhalation Injury

    Stratifies severity of inhalation injury on chest CT.

    INSTRUCTIONS

    Requires chest CT to calculate. This tool computes RADS for a single slice; to obtain full score (average RADS per slice), add RADS for all slices and divide by number of slices.

    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with suspected or diagnosed inhalation injury.
    • Best used in conjunction with flexible bronchoscopy.
    • Score derived from sheep model and validated retrospectively in human cohorts, with limited validation in prospective human clinical trials.
    • Requires assessment of each CT slice, which can be time-consuming.
    • Higher RADS 24 hours after smoke inhalation seems to correlate with greater smoke exposure and severity of lung injury.
    • Using chest CT in the evaluation of inhalation injury has limitations, including questionable optimal timing of CT and interpretation of abnormal CT findings in the setting of a negative bronchoscopy.
    • Currently, no single tool accurately and reliably risk-stratifies and prognosticates patients with smoke inhalation injury.
    • Can be a useful adjunct to determine severity of inhalational injury to the lungs.
    • A multicenter prospective cohort study to develop a scoring system for inhalation injury based on clinical, radiographic, bronchoscopic, and biochemical parameters is underway by the American Burn Association.
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3
    Normal
    0
    Increased interstitial markings
    +1
    Ground glass opacification
    +2
    Consolidation
    +3

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. John S. Oh

    About the Creator

    John S. Oh, MD, FACS, is a trauma critical care surgeon and director of surgical critical care at Penn State Hershey Medical Center. He served as chief of general surgery at the Walter Reed National Military Medical Center and director of the division for global surgery at the Uniformed Services University of the Health Sciences. Dr. Oh's primary research interests include combat casualty care, traumatic brain injury, and prehospital injury care.

    To view Dr. John S. Oh's publications, visit PubMed

    Are you Dr. John S. Oh? 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. John S. Oh
    Are you Dr. John S. Oh?
    Partner Content
    Content Contributors
    • Pujan H. Patel, MD