For year EMS providers have relied on certain clinical signs and symptoms to predict clinically unstable trauma patients and the need for emergent transport for definitive surgical care. Commonly EMS providers have used HR>120, systolic BP<90mmHg, and MAP’s <60mmHg as benchmarks for clinically unstable patients. However, these indicators can frequently be misleading if not carefully evaluated in the context of a patient’s overall clinical presentation leading prehospital providers to underestimate the severity of our patient's injuries or illness.  The Shock Index and Modified Shock Index can help providers make better decisions about prehospital trauma care.

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