# TASH score (Trauma Associated Severe Hemorrhage) TASH score Status: LIVE Price: $0.005 USDC `GET /api/calc/tash` HTML: https://magentlab.com/docs/tash Markdown: https://magentlab.com/docs/tash.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the seven Yücel 2006 TASH (Trauma Associated Severe Hemorrhage) nested less-than point bands and return the published 0–28 total as a surrogate for mass transfusion after multiple trauma. ## When to use When an agent needs the published Yücel 2006 TASH point total and must not invent a logistic mass-transfusion probability, an MTP activation, or a transfusion order. ## When not to use - Not a medical device and not a transfusion order. magent does not decide whether to transfuse or activate a massive-transfusion protocol (MTP). - This is Yücel 2006 TASH only. It is not the ABC (assessment of blood consumption) score. Do not interchange them. - Intra-abdominal fluid (FAST) and fracture AIS are caller-assigned. magent does not read imaging or assign AIS. - Mass transfusion in the derivation cohort was ≥10 units PRBC from ER to ICU. This tool returns the published point total only, not a logistic probability. ## Formula ``` TASH = SBP (<100:4, <120:1) + Hb g/dL (<7:8, <9:6, <10:4, <11:3, <12:2) + intra-abdominal fluid 3 + fracture AIS (3-4:3, 5:6) + HR>120:2 + BE mmol/L (<-10:4, <-6:3, <-2:1) + male 1; nested less-than highest band only; max 28 ``` ## Citation [Trauma Associated Severe Hemorrhage (TASH)-Score: probability of mass transfusion as surrogate for life threatening hemorrhage after multiple trauma](https://doi.org/10.1097/01.ta.0000220386.84012.bf) Yücel N, Lefering R, Maegele M, et al. J Trauma. 2006;60(6):1228-1236 DOI: [10.1097/01.ta.0000220386.84012.bf](https://doi.org/10.1097/01.ta.0000220386.84012.bf) ## Worked example ### Published worked example (score 9) Given: `base_excess_mmol_l=-4, fracture_ais=3, heart_rate_bpm=110, hemoglobin_g_dl=10.5, intra_abdominal_fluid=false, sex=male, systolic_mm_hg=110` 1. SBP 110 → 1; Hb 10.5 g/dL → 3; FAST false → 0; AIS 3 → 3; HR 110 → 0; BE −4 → 1; male → 1 2. Score = 9 (max 28) ### No scoring bands Given: `base_excess_mmol_l=0, fracture_ais=0, heart_rate_bpm=80, hemoglobin_g_dl=12, intra_abdominal_fluid=false, sex=female, systolic_mm_hg=120` 1. SBP ≥120 → 0; Hb ≥12 → 0; FAST false → 0; AIS 0 → 0; HR ≤120 → 0; BE ≥ −2 → 0; female → 0 2. Score = 0 (max 28) ## Also searched as - TASH score - Trauma Associated Severe Hemorrhage - TASH-Score - Yücel TASH - TASH massive transfusion - TASH hemorrhage score - trauma TASH ## Parameters - `systolic_mm_hg` (integer, required): Arrival systolic blood pressure in mm Hg (integer 0-300). Nested less-than: <100 scores 4; <120 (and not <100) scores 1; ≥120 scores 0. Highest matching band only. - `hemoglobin_g_dl` (number, optional): Hemoglobin in g/dL (3-22). Provide this or hemoglobin_g_l, not both. Nested less-than: <7 scores 8; <9 scores 6; <10 scores 4; <11 scores 3; <12 scores 2; ≥12 scores 0. Highest matching band only. - `hemoglobin_g_l` (number, optional): Hemoglobin in g/L (30-220). Converted as hemoglobin_g_dl = hemoglobin_g_l / 10. Provide this or hemoglobin_g_dl, not both. - `intra_abdominal_fluid` (boolean, required): Intra-abdominal fluid (FAST) as assigned by the caller (Yücel 2006). true or false. true scores 3. magent does not interpret FAST images. - `fracture_ais` (integer, required): Caller-assigned AIS for complex long bone and/or pelvic fractures. Must be 0 (none), 3, 4, or 5. 3 or 4 scores 3; 5 scores 6. magent does not assign AIS from imaging. - `heart_rate_bpm` (integer, required): Arrival heart rate in beats per minute (integer 30-220). >120 scores 2; 120 does not. - `base_excess_mmol_l` (number, required): Admission base excess in mmol/L (−30 to 20). Nested less-than: < −10 scores 4; < −6 scores 3; < −2 scores 1; ≥ −2 scores 0. Highest matching band only. - `sex` (string, required): Sex as assigned by the caller. male scores 1; female scores 0. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/tash` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "base_excess_mmol_l": "-4", "fracture_ais": "3", "heart_rate_bpm": "110", "hemoglobin_g_dl": "10.5", "intra_abdominal_fluid": "false", "sex": "male", "systolic_mm_hg": "110" }, { "base_excess_mmol_l": "-4", "fracture_ais": "3", "heart_rate_bpm": "110", "hemoglobin_g_dl": "10.5", "intra_abdominal_fluid": "false", "sex": "male", "systolic_mm_hg": "110" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/tash Example 200: ```json { "count": 2, "path": "/api/calc/tash", "items": [ { "components": [ { "value": 110, "factor": "systolic", "points": 1, "present": true }, { "value": 10.5, "factor": "hemoglobin", "points": 3, "present": true }, { "factor": "intra_abdominal_fluid", "points": 0, "present": false }, { "value": 3, "factor": "fracture_ais", "points": 3, "present": true }, { "value": 110, "factor": "heart_rate", "points": 0, "present": false }, { "value": -4.0, "factor": "base_excess", "points": 1, "present": true }, { "value": "male", "factor": "male", "points": 1, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Yücel N, Lefering R, Maegele M, et al.", "doi": "10.1097/01.ta.0000220386.84012.bf", "id": "yucel-2006", "pmid": "16766965", "source": "J Trauma. 2006;60(6):1228-1236", "title": "Trauma Associated Severe Hemorrhage (TASH)-Score: probability of mass transfusion as surrogate for life threatening hemorrhage after multiple trauma" }, "formula": "tash", "formula_expression": "TASH = SBP (<100:4, <120:1) + Hb g/dL (<7:8, <9:6, <10:4, <11:3, <12:2) + intra-abdominal fluid 3 + fracture AIS (3-4:3, 5:6) + HR>120:2 + BE mmol/L (<-10:4, <-6:3, <-2:1) + male 1; nested less-than highest band only; max 28", "max_score": 28, "score": 9, "sex": "male", "systolic_mm_hg": 110, "heart_rate_bpm": 110, "hemoglobin_g_dl": 10.5, "base_excess_mmol_l": -4.0, "fracture_ais": 3, "intra_abdominal_fluid": false }, { "components": [ { "value": 110, "factor": "systolic", "points": 1, "present": true }, { "value": 10.5, "factor": "hemoglobin", "points": 3, "present": true }, { "factor": "intra_abdominal_fluid", "points": 0, "present": false }, { "value": 3, "factor": "fracture_ais", "points": 3, "present": true }, { "value": 110, "factor": "heart_rate", "points": 0, "present": false }, { "value": -4.0, "factor": "base_excess", "points": 1, "present": true }, { "value": "male", "factor": "male", "points": 1, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Yücel N, Lefering R, Maegele M, et al.", "doi": "10.1097/01.ta.0000220386.84012.bf", "id": "yucel-2006", "pmid": "16766965", "source": "J Trauma. 2006;60(6):1228-1236", "title": "Trauma Associated Severe Hemorrhage (TASH)-Score: probability of mass transfusion as surrogate for life threatening hemorrhage after multiple trauma" }, "formula": "tash", "formula_expression": "TASH = SBP (<100:4, <120:1) + Hb g/dL (<7:8, <9:6, <10:4, <11:3, <12:2) + intra-abdominal fluid 3 + fracture AIS (3-4:3, 5:6) + HR>120:2 + BE mmol/L (<-10:4, <-6:3, <-2:1) + male 1; nested less-than highest band only; max 28", "max_score": 28, "score": 9, "sex": "male", "systolic_mm_hg": 110, "heart_rate_bpm": 110, "hemoglobin_g_dl": 10.5, "base_excess_mmol_l": -4.0, "fracture_ais": 3, "intra_abdominal_fluid": false } ] } ``` ## Response fields - `formula` (string): tash - `formula_expression` (string): Exact expression used - `score` (integer): TASH points 0-28 - `max_score` (integer): Always 28 - `systolic_mm_hg` (integer): Systolic blood pressure used (mm Hg) - `hemoglobin_g_dl` (number): Hemoglobin used in g/dL (g/L inputs converted as g/dL = g/L / 10) - `intra_abdominal_fluid` (boolean): Caller-assigned FAST / intra-abdominal fluid flag used - `fracture_ais` (integer): Caller-assigned complex long-bone/pelvic fracture AIS used (0, 3, 4, or 5) - `heart_rate_bpm` (integer): Heart rate used (bpm) - `base_excess_mmol_l` (number): Base excess used (mmol/L) - `sex` (string): Sex used: male or female - `components` (array): Per-factor points - `citation` (object): Yücel et al. J Trauma 2006 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 110, "factor": "systolic", "points": 1, "present": true }, { "value": 10.5, "factor": "hemoglobin", "points": 3, "present": true }, { "factor": "intra_abdominal_fluid", "points": 0, "present": false }, { "value": 3, "factor": "fracture_ais", "points": 3, "present": true }, { "value": 110, "factor": "heart_rate", "points": 0, "present": false }, { "value": -4.0, "factor": "base_excess", "points": 1, "present": true }, { "value": "male", "factor": "male", "points": 1, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Yücel N, Lefering R, Maegele M, et al.", "doi": "10.1097/01.ta.0000220386.84012.bf", "id": "yucel-2006", "pmid": "16766965", "source": "J Trauma. 2006;60(6):1228-1236", "title": "Trauma Associated Severe Hemorrhage (TASH)-Score: probability of mass transfusion as surrogate for life threatening hemorrhage after multiple trauma" }, "formula": "tash", "formula_expression": "TASH = SBP (<100:4, <120:1) + Hb g/dL (<7:8, <9:6, <10:4, <11:3, <12:2) + intra-abdominal fluid 3 + fracture AIS (3-4:3, 5:6) + HR>120:2 + BE mmol/L (<-10:4, <-6:3, <-2:1) + male 1; nested less-than highest band only; max 28", "max_score": 28, "score": 9, "sex": "male", "systolic_mm_hg": 110, "heart_rate_bpm": 110, "hemoglobin_g_dl": 10.5, "base_excess_mmol_l": -4.0, "fracture_ais": 3, "intra_abdominal_fluid": false } ``` ## Errors - HTTP 400 `invalid_rts_systolic`: systolic_mm_hg must be an integer from 0 to 300. Returned before settlement; you are not charged. - HTTP 400 `invalid_hemoglobin`: hemoglobin_g_l (30-220) or hemoglobin_g_dl (3-22) is required, not both. Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_tash_fracture_ais`: fracture_ais must be 0 (none), 3, 4, or 5 (Yücel 2006 AIS for complex long bone and/or pelvic fractures). Returned before settlement; you are not charged. - HTTP 400 `invalid_heart_rate`: heart_rate_bpm must be an integer from 30 to 220 Returned before settlement; you are not charged. - HTTP 400 `invalid_base_excess`: base_excess_mmol_l must be a number from -30 to 20. Returned before settlement; you are not charged. - HTTP 400 `invalid_sex`: sex must be female or male Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [ABC score](https://magentlab.com/docs/abc-score) — Sum the four Nunez 2009 ABC (assessment of blood consumption) arrival factors and return score_ge_2 at the published ≥2 cutoff. - [ISS](https://magentlab.com/docs/iss) — Compute the Baker 1974 Injury Severity Score as the sum of squares of the three highest caller-assigned AIS body-region grades, or 75 if any region is AIS 6. - [RTS](https://magentlab.com/docs/rts) — Compute Champion 1989 coded GCS, SBP, and respiratory-rate values, the triage T-RTS sum, and the weighted RTS used for outcome evaluation. ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.