MESS Score (Mangled Extremity Severity Score)
These diagrams and illustrations have been designed to help you learn, memorise and recall key information.
Skeletal / soft-tissue injury
Low energy (stab; simple fracture; pistol gunshot wound): 1
Medium energy (open or multiple fractures, dislocation): 2
High energy (high speed MVA or rifle GSW): 3
Very high energy (high speed trauma + gross contamination): 4
Limb ischemia
Pulse reduced or absent but perfusion normal: 1*
Pulseless; paresthesias, diminished capillary refill: 2
Cool, paralyzed, insensate, numb: 3*
Shock
Systolic BP always > 90 mm Hg: 0
Hypotensive transiently: 1
Persistent hypotension: 2
Age (years)
< 30: 0
30-50: 1
> 50: 2
* Score doubled for ischemia > 6 hours
