Quote from Bocephus71RN-BSN
CMS as I was taught is related to circulation, motion and sensation. However maybe in the ER the abbreviation is different. For example, if a pt. has a cast placed proximally you would want to assess neurovascular function which would include circulation and not color. Whether or not the fingers have capillary refill or if a pulse is present distal to the cast, or in the case that someone has trauma and you are doing a neurovascular assessment to make sure they are not developing compartment syndrome. In which case color and temperature are moot points, you would be testing for circulation first. However, if the extremity was cyanotic and cold to touch this is indicative that circulation is impaired, but the hospitals I've worked at it was related directly to circulation (ie. if pulses are present or not and the grade of the pulses if palpable or heard via doppler or capillary refill being <3seconds. Thats how we do it, but new insight on the topic is welcomed, maybe it is not exactly the same facility to facility or from different nursing specialties.
CMTS is just another way of assessing CMS; just the abbreviation is somewhat different. See, when you assess circulation using capillary refill (a measure of peripheral perfusion), you press the nailbed until it is white, then assess the time it takes for the color
to return to normal. Or, like you said, a patiet who has cold, cyanotic extremities has some alteration in circulation. I personally like using CMTS because I think color and temperature are important - but you are right, color and temperature are only two components of circulation. Assessing pulses is an essential component which objectively measures blood flow (rather than saying "pt's right arm appears pale" - what's pale to me may not be pale to someone else). Perhaps I should call it "CCMTS" (circulation, color, motion, temperature, sensation)?
CMTS works for me, and perhaps others prefer CMS. Thanks for pointing out the differences. Assessing pulses is EXTREMELY important, and I should have emphasized that more.