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Simplified Motor Score (SMS)

Simplifies assessment of head trauma patients compared to the GCS.

Advice

The Simplifed Motor Score (SMS) is defined as:

  • Obeys commands=2
  • Localizes to pain=1
  • Withdrawals to pain or worse=0.

Patients with a SMS of <2 are at significantly increased risk of having a significant traumatic brain injury and prompt evaluation and head CT imaging is indicated for these patients.

Management

Clinical management decisions should not be based solely on the SMS score, though scores of < 2 are associated with worse clinical outcomes. The threshold for obtaining a head CT in these patients should be low.

Critical Actions

As with the GCS, management decisions should be based on the patients overall clinical picture. However the SMS appears to have similar sensitivity to the GCS for predicting patients at risk of significant TBI.

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