Mangled Extremity Severity Score for prediction of amputation (MESS)
Calculator
When to use
Limb ischemia
Pulse reduced/absent, perfusion normal ischemia < 6 hours)
Pulseless, paresthesias, diminished capillary refill ischemia for < 6 hours)
Cool, paralysed, numb/insensate ischemia for < 6 hours)
Pulse reduced/absent, perfusion normal ischemia > 6 hours)
Pulseless, paresthesias, diminished capillary refill ischemia for > 6 hours)
Cool, paralysed, numb/insensate ischemia for > 6 hours)
Patient age
< 30
30-50
≥ 50
Shock
Systolic blood pressure > 90 mmHg consistently
Transient hypotension
Persistent hypotension
Skeletal/soft tissue injury
Low energy stab, simple fracture, "civilian" gunshot)
Medium energy open/multiple fractures, dislocation)
High energy close-range shotgun or "military" gunshot, crush injury)
Very high energy soft-tissue avulsion, high speed trauma with gross contamination)
Calculation
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