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CAISS CERTIFICATION STUDY GUIDE Questions
and Answers A+ Grade 2025-
Origins of AIS (3) - ✔✔1) Standardized system
Classify type/severity of injury from MVC
Consensus
Injury descriptors are organized? - ✔✔Anatomically
Injury severity is ranked relative to its importance to? - ✔✔The whole body
AIS reflects severity of single injuries and are unaffected by what three things? - ✔✔1) time
sequela
outcome
What type of scale does AIS use? - ✔✔6 point ordinal scale
Which type of measurement is more variable? Anatomic or Physiologic? - ✔✔Physiologic
Is clinical training necessary for collecting injury data? - ✔✔NO
AIS is based on what three (3) factors? - ✔✔1) anatomically- based
consensus driven
global
Severity is NOT contingent upon what two (2) factors? - ✔✔1) Outcome
- time
Numerical ranking of severity: 1 - ✔✔minor
Numerical ranking of severity: 2 - ✔✔moderate
Numerical ranking of severity: 3 - ✔✔serious
Numerical ranking of severity: 4 - ✔✔severe
Numerical ranking of severity: 5 - ✔✔critical
Numerical ranking of severity: 6 - ✔✔maximum (currently untreatable)
Is mortality a sole determinant of AIS severity? - ✔✔NO
Are all AIS data comparable from year to year? - ✔✔NO (updates)
Is "DEATH" part of the severity scale? - ✔✔NO
Is a patient who dies automatically assigned the highest AIS severity of 6? - ✔✔NO (patients w/ minor injuries can die)
Does a linear relationship exist between AIS severity codes? - ✔✔NO (AIS 4 is more, NOT twice as severe as AIS 2)
Are all injuries within the same AIS code strictly compatible? - ✔✔NO (tibia fx & alveolar ridge are both AIS - 2, although one may be worse than the other, both are considered 'moderate')
What AIS code is assigned to a patient with inadequate information regarding an injury? - ✔✔ 9
How many chapters are in the AIS dictionary? - ✔✔9 (not the same as body regions)
Parenthesis in the AIS dictionary indicate what? - ✔✔synonyms or definitions for injury types
Brackets in the AIS dictionary indicate what? - ✔✔inclusionary/exclusionary info, OIS Grades
Boxed bold type in the AIS dictionary indicates what? - ✔✔directives to assist coder in appropriate use of specific description
Semicolons in the AIS dictionary indicate what? - ✔✔separate injury descriptors that are comparable in severity
Italics in the AIS dictionary indicate what? - ✔✔proper-named injuries/structures, OIS grades
Does AIS assess the severity of multiple injuries? - ✔✔NO (single injury severity only)
The injury Severity Score (ISS) is defined as what? - ✔✔Sum of the squares of highest AIS in each of 3 most severely injured ISS body regions.
What are the six body regions used in the ISS? - ✔✔1) head & neck
face
chest
abdomen & pelvic organs
extremities & pelvic girdle
external
Asphyxia is assigned to which ISS body region? - ✔✔HEAD & neck
Thoracic spine injuries are assigned to which ISS body region? - ✔✔Chest
Drowning is assigned to which ISS body region? - ✔✔Chest
Lumbar spine lesions would be assigned to which ISS region? - ✔✔Abdomen & pelvic contents
Are external injuries coded independent of their body region? - ✔✔YES
Hypothermia, electrical injuries, and whole body injuries are coded to which ISS region? - ✔✔External
The ISS score ranged from to _____? - ✔✔1 to 75
What are the two ways an ISS of 75 can be achieved? - ✔✔1) AIS of 5 in each of three different body regions
- AIS of 6 in a single body region
Do patients with an AIS 9 achieve an accurate ISS score? - ✔✔NO
Can less than three regions be used to calculate an ISS? - ✔✔YES
Can more than three regions be used to calculate an ISS? - ✔✔NO
Do all ISS scores have the same mortality rates? - ✔✔NO (depends on body regions affected)
Assigning injuries to too few body regions results in what? - ✔✔underestimation of ISS
Assigning injuries to too many body regions results in what? - ✔✔overestimation of ISS
Are complications or sequela included in the definition of an injury? - ✔✔NO
Define injury? - ✔✔Anatomic lesion resulting from transfer of injury.
Are sequela or outcomes coded as injuries? - ✔✔NO (ex: death, blindness, obstruction, miscarriage, deafness, swelling-except brain)
Are injury etiologies (causes) related to AIS injury scores? - ✔✔NO
Can injuries be assumed based on a particular outcome occurrence? - ✔✔NO
If an AIS code of 6 is assigned, is it acceptable to stop coding subsequent injuries? - ✔✔NO
Is death automatically coded as an AIS 6? - ✔✔NO
Can an AIS of 1 result in death? - ✔✔YES (rare)
Are cord lesions and vertebral fxs coded separately? - ✔✔NO
Penetrating injuries that do not injure underlying structures should be coded in what ISS body region? - ✔✔External
Injuries that result from energy dissipated from a penetrating wound are called direct or indirect? - ✔✔indirect
With penetrating injuries to internal structures, is the overlying skin injury coded separately? - ✔✔NO
Bullet wounds/penetrating injuries resulting in fx are coded as open or closed fractures? - ✔✔OPEN
When detailed information regarding an injury is lacking, what descriptor is often used? - ✔✔NFS
NFS can refer to what two components of a code? - ✔✔1) injury unspecified
- severity unspecified
Should patients with AIS code 9 injuries be included in research studies? - ✔✔NO
Fracture involving the joint? - ✔✔articular fracture
fracture type with 3 or more fragments with the proximal and distal fragments not touching? - ✔✔complex fracture
fracture type where skin overlying the fracture is lacerated and communicates with the fracture? - ✔✔open fracture
fracture type where skin overlying the fracture in not lacerated? - ✔✔closed fracture
fracture in which 2 ends of bone are not aligned? - ✔✔displaced fracture
fracture type that includes multiple bone fragments? - ✔✔comminuted fracture
Sprains are to? - ✔✔joints (knee, ankle, etc)
Strains are to? - ✔✔muscles & tendons
Injury type involving massive destruction of body part w/damage to underlying body systems (skeletal, organ, vascular) - ✔✔crush injury
A vessel puncture or perforation is also known as a. - ✔✔laceration
superficial, incomplete circumferential involvement, blood loss <20% - ✔✔minor vessel laceration
The term "transection" should be coded as complete or incomplete? - ✔✔complete
(T/F) When a vessel injury and related organ injury occur together, if the descriptor includes the vessel injury in the organ injury descriptor it should still be coded separately. - ✔✔FALSE (do not code vessel injury separately if included in organ injury descriptor)
Are branches of vessels coded as separate injuries? - ✔✔NO (unless named/listed in descriptor)
When more than one injury claims the qualifier "blood loss > 20%," the blood loss is assigned to which associated injury? - ✔✔most severe
Blood loss of 20% in a 100 kg patient is approximately how many cc? - ✔✔1500 cc
List the four (4) types of injures defined as penetrating? - ✔✔1) GSW
Stabbing
impalement
spearing-type
Penetrating injuries that do not involve internal organs or structures should be coded under what ISS body region? - ✔✔External
A penetrating injury to the skull is coded under what ISS body region? - ✔✔Head/Neck
A penetrating injury to the face w/ massive destruction is coded under what ISS body region? - ✔✔Face
Are entry/exit wounds reflected in the severity of internal organ/structure injuries? - ✔✔YES
If a single penetrating injury to the brain involves more than one structure (entry to cerebrum, exit cerebellum) do you code each region separately? - ✔✔NO (use whole area section)
(T/F) When a penetrating injury exists, and using the penetrating code results in a higher AIS than using subsequent qualifiers, the higher AIS penetrating code should be used. - ✔✔True
Vague descriptions such as "blunt trauma" or "closed head injury" should be assigned which AIS code? - ✔✔ 9
When assigning severity codes, the coder should use the physicians description of the injury or the AIS definition? - ✔✔AIS definition
If the physicians OIS grading differs from the AIS definition of the injury, which should be used for coding? - ✔✔AIS definition
If no description is available for a solid organ injury other than the OIS grade, is it acceptable to use this information for assigning an AIS code? - ✔✔YES
(T/F) In order to assign an AIS code with "blood loss > 20%" you must know to what area of the body the blood loss is linked. - ✔✔TRUE
Are dimensions of lesions used to determine injury severity? - ✔✔YES
In an adult, 100% blood volume is considered approximately how many cc? - ✔✔5000 cc
(T/F) The severity of codes in AIS are NOT age adjusted in some categories. - ✔✔FALSE
Fractures may be best described in what type of report? - ✔✔radiology
Organ injuries may best be described in what type of report? - ✔✔operative
Can patient or bystander reports of LOC be used for coding purposes? - ✔✔NO
Black or blue marks resulting from blunt force causing tiny underlying blood vessels to burst and leak into skin but do not cause a break in the skin are known as what? - ✔✔contusions
Ecchymosis, subcutaneous hematoma, bruise, and bump are all considered what type of external injury?
Tearing or ripping apart of tissues from blunt or penetrating force is known as what type of injury? - ✔✔laceration
Ripping or tearing away of all layers of skin in which a portion is separated from underlying tissues often creating a flap is known as what type of injury? - ✔✔avulsion
Traumatic removal of skin and SQ tissue separating tissue planes from their blood supply, esp. from a limp is known as what type of injury? - ✔✔degloving
(T/F) Degloving injuries may be open or closed. - ✔✔TRUE
Which are typically more extensive - degloving or avulsion? - ✔✔degloving
Soft tissue injuries are dispersed across body regions in the AIS book and are coded as what ISS body region? - ✔✔external
When an external injury occurs without underlying injury, it is coded to the specific AIS region, but assigned to the ISS region. - ✔✔body AIS; external ISS
When should the AIS body region external codes be used for skin injuries? - ✔✔no body region info is available
(T/F) When a skin injury (abrasion, contusion, etc.) occurs over an underlying injury they should be coded separately to the specific body region. - ✔✔TRUE (ex. open fx, penetrating)
1st degree burn is described as? - ✔✔superficial
2nd degree burn is described as? - ✔✔partial thickness
3rd degree burn is described as? - ✔✔full thickness
Is age adjustment required for burns? - ✔✔YES
When burns are only described as combined degrees, the coder should choose the least or most severe code? - ✔✔most severe
When burns occur in varying degrees, which type of burns are coded separately from the others? - ✔✔1st degree
When either 2nd and/or 3rd degree burns are < 10% TBSA, should the 2nd and 3rd degree burns be coded separately or combined? - ✔✔separately
If 2nd and 3rd degree burns combined are > 10% TBSA, they should be coded separately or combined? - ✔✔combined
Burn amputations should be coded to which ISS body region? - ✔✔specific to body part
Are burns coded separately from burn amputations they cause? - ✔✔NO
If an electrical injury causes a "flash" burn, should the burn injury be coded separately? - ✔✔NO
Frostbite is assigned to which ISS body region? - ✔✔external
Asphyxia/suffocation is assigned to which ISS body region? - ✔✔Head
A transverse horizontal maxillary alveolar fracture, or palate facial disjunction (Guerin) is known as what type of LeFort Fx? - ✔✔LeFort I
A pyramidal facial disjunction is known as what type of LeFort Fx? - ✔✔LeFort II
A craniofacial disjunction is known as what type of LeFort Fx? - ✔✔LeFort III
(T/F) The size and associated severity of soft tissue injuries is the same across all body regions. - ✔✔FALSE (face > 10cm, other > 20cm)
Are bilateral injures to the eyes and ears usually coded combined or separately? - ✔✔separate
Traumatic enucleation of the eye is coded as what type of external injury? - ✔✔avulsion
Bilateral maxilla or mandible fractures are coded separately or combined? - ✔✔combined
Nose fractures by definition are included in which LeFort Fxs and should not be coded separately? - ✔✔LeFort II and III
Should minimally displaced facial fractures be coded as displaced? - ✔✔NO (must be significantly displaced)
Multiple and complex fxs involving the middle and lower, upper and middle, or all three locations of the face that are NOT LeFort fractures are called what? - ✔✔Panfacial
What facial bone must be fractured to have a LeFort fracture? - ✔✔pterygoid plate
Can you have more than one type LeFort fracture? - ✔✔YES (one on each side)
Which type of LeFort fracture involves a "floating palate" fracture pattern? - ✔✔LeFort I
The cheek bone is also known as what? - ✔✔malar complex
What are other names for fractures of the zygoma? - ✔✔tripod fracture
What bone is associated with the malar complex (cheek)? - ✔✔zygoma
what bones are involved with NOE fractures? - ✔✔nose, orbit, ethmoid
high velocity injury resulting in multiple facial fractures in several different regions - ✔✔panfacial fracture
Below what anatomic landmark are the trachea and esophagus coded to the chest ISS region? - ✔✔sternal notch
Which portion of the aorta is coded to the chest ISS region? - ✔✔thoracic
The larynx/vocal cords are coded to which ISS body region? - ✔✔Head/Neck
The shoulders are coded to which ISS body region? - ✔✔extremities/pelvic girdle
(T/F) A "crush" injury to the thoracic region must be bilateral in nature? - ✔✔TRUE
A "sucking" wound of the chest indicates that it is open or closed? - ✔✔open
slick membrane that lines the chest cavity - ✔✔Parietal pleura
What membrane lines the viscera? - ✔✔visceral pleura
"Blast" and inhalation injuries in the chest are coded to which organ? - ✔✔lungs
what structure are ingestion injuries coded to? - ✔✔esophagus
Lung lacerations must be substantiated by , , or. - ✔✔CT, operative report, autopsy
What should be used when a specific artery or vein is not named in the AIS description but is injured? - ✔✔other named
"Incomplete transection" vessel injuries are coded as what in AIS? - ✔✔incomplete circumferential involvement
What two ISS body regions may the aorta and vena cava be coded under depending on the location of their injury? - ✔✔chest
abdomen
The lumbar spinal cord and lumbar vertebrae are assigned to which ISS body region? - ✔✔abdomen & pelvic contents
Avulsion, complex, rupture, tissue loss, and deep are all synonyms for what severity of organ injury? - ✔✔massive
What type of organ injury involves the ripping away of an organ from its vascular attachment? - ✔✔avulsion
"No perforation" is defined as a thickness laceration (such as serosal tear) - ✔✔partial
Is a perforation considered a complete transection? - ✔✔NO
"perforation" is defined as a thickness laceration. - ✔✔full
When two parts of a structure are completely separated from each other it is known as what type of injury? - ✔✔transection
T/F OIS grades should not be used as a substitute for clinical descriptions of injuries. - ✔✔True
If retroperitoneal hemorrhage/hematoma occurs in combination with an associated injury, it should be coded as combined or separate? - ✔✔combined
If a vessel injury occurs in combination with an associated organ and it is included in the organ injury AIS description, it should be coded as combined or separate? - ✔✔combined
Vessel injuries are only coded separate if they and. - ✔✔1) are isolated injuries
- are not included in the organ injury description
When an injury occurs at the junction of the duodenum and the jejunum, the injury should be coded to which part of the intestine? - ✔✔jejunum
Injuries to bilateral abdominal organs such as the kidneys are coded as combined or separate? - ✔✔separate
(T/F) If OIS grading descriptions are NOT available and no other descriptors are mentioned, it is acceptable to use the terms "minor, major, or massive" as severity descriptors of solid organ injuries. - ✔✔TRUE
Is a positive DPL (diagnostic peritoneal lavage) a codeable injury in and of itself? - ✔✔NO
