Clinical Practice Procedures: Assessment/COAST score
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Date October, 2016
Purpose To ensure a consistent procedural approach to determining the COAST score.
Scope Applies to all QAS clinical staff.Author Clinical Quality & Patient Safety Unit, QAS
Review date October, 2018
URL https://ambulance.qld.gov.au/clinical.html
422QUEENSLAND AMBULANCE SERVICE
COAST score
The coagulopathy of severe trauma (COAST) score is a rapid and highly specific predictor of acute traumatic coagulopathy (ATC) in blunt trauma.[1]
It is determined by assessing five objective descriptors based on physical entrapment, systolic blood pressure, temperature, chest decompression and abdominal or pelvic content injury. All descriptors may be assessed using pre-hospital variables without the use of pathology or radiological testing.
The purpose of the COAST score is to accurately identify patients likely to develop ATC.
Indications
Contraindications
• Nil in this setting
Complications
• History of blunt or penetrating trauma
• To assess P.A.T.C.H. / PROPHIICY enrolment
eligibility
• Nil in this setting
• Allocate the appropriate COAST score (0 to 7) by determining the
value and score associated with each of the five variables.
Additional information
• A COAST score or ≥ 3 is a good predictor of patients requiring tranexamic acid.
e
COAST SCORECOAST SCORECOAST SCORE
Variable Value Score
Entrapment (e.g. in vehicle) YesNo
10
Systolic blood pressure (mmHg ) > 10090 − 100
< 90
012
Temperature (0C ) > 3532 − 35
< 32
012
Major chest injury likely to require intervention (e.g. decompression, chest tube)
YesNo
10
Likely intra-abdominal or pelvic injury YesNo
10
October, 2016
Figure 3.22
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