Table 1

Definition of secondary insult grades. Each derangement must be sustained for at least 5 minutes to be deemed a secondary insult, with the exception of pyrexia, which must last at least 60 minutes

Insult categoryGrade 1Grade 2Grade 3
Raised ICPmean ⩾20 mm Hgmean ⩾30 mm Hgmean ⩾40 mm Hg
Hypotensionmean ⩽70 mm Hgmean ⩽55 mm Hgmean ⩽40 mm Hg
or systolic ⩽90 mm Hgor systolic ⩽70 mm Hgor systolic ⩽50 mm Hg
Hypertensionmean ⩾110 mm Hgmean ⩾130 mm Hgmean ⩾150 mm Hg
or systolic ⩾160 mm Hgor systolic ⩾190 mm Hgor systolic ⩾220 mm Hg
Low CPPmean ⩽60 mm Hgmean ⩽50 mm Hgmean ⩽50 mm Hg
HypoxiaSaO2 ⩽90%SaO2⩽85%SaO2 ⩽80%
PyrexiaTemp. ⩾38 CTemp ⩾39°CTemp ⩾40°C
TachycardiaHRT ⩾120 bpmHRT ⩾135 bpmHRT ⩾150 bpm
BradycardiaHRT ⩽50 bpmHRT ⩽40 bpmHRT ⩽30 bpm