Normal capillary refill
and systolic BP >100

Delayed capillary refill
or systolic BP is 85-99

No capillary refill or
systolic BP <85

2

1

0

Normal

Abnormal
(labored, shallow, or rate>35

Absent

2

1

0

Abdomen and thorax not tender

Abdomen and/or thorax tender

Abdomen rigid, thorax flail, or
deep penetrating injury to either

2

1

0

Normal - obeys commands

Respons only to pain, no posturing

Only posturing or flaccid to pain

2

1

0

Normal - oriented

Confused or inappropriate

No intelligible words or silence

2

1

0