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The Revised Trauma Score is a validated triage tool used in pre-hospital and emergency settings. It helps predict injury severity and survival probability. RTS should be used in conjunction with mechanism of injury, anatomy of injury, and clinical judgment. Not a substitute for comprehensive trauma assessment.
Physiologic scoring system for trauma triage and outcome prediction
Normal: 90-140 mmHg
Normal: 12-20 breaths/min
| Glasgow Coma Scale | Systolic BP (mmHg) | Respiratory Rate | Coded Value |
|---|---|---|---|
| 13-15 | >89 | 10-29 | 4 |
| 9-12 | 76-89 | >29 | 3 |
| 6-8 | 50-75 | 6-9 | 2 |
| 4-5 | 1-49 | 1-5 | 1 |
| 3 | 0 | 0 | 0 |
RTS = (0.9368 × GCS code) + (0.7326 × SBP code) + (0.2908 × RR code)
The coefficients are derived from regression analysis and represent the relative importance of each parameter in predicting survival.
The Revised Trauma Score (RTS) is a physiologic scoring system for trauma patients developed by Champion et al. in 1989. It uses three easily measurable parameters to quickly assess trauma severity and predict outcomes.
RTS <11 (or coded RTS <4): Strong indicator for trauma center transport
Many trauma centers use RTS as one criterion for activation:
RTS is often used as part of the CDC Field Triage Decision Scheme (Step 1: Physiologic criteria). Abnormalities in any RTS component warrant trauma center evaluation.
The Revised Trauma Score is a key component of the Trauma and Injury Severity Score (TRISS) methodology, which combines physiologic (RTS), anatomic (ISS - Injury Severity Score), and demographic data (age) to predict probability of survival.
The Revised Trauma Score (RTS) is an updated version of the original Trauma Score developed by Champion. RTS uses weighted components (GCS, SBP, RR) with regression-derived coefficients, while the original Trauma Score used five parameters with simpler scoring. RTS has better predictive accuracy.
RTS is a physiologic score based on vital signs, calculable immediately in the field or ED. ISS (Injury Severity Score) is an anatomic score based on specific injuries, typically calculated after imaging and full evaluation. Use RTS for triage; ISS for outcome prediction after full workup.
Generally, coded RTS <4 (or calculated RTS <11) is an indication for trauma center transport. However, many EMS systems use any abnormality in the three components (GCS <14, SBP <90, RR <10 or >29) as triage criteria. Local protocols vary.
No. RTS was developed and validated for adult trauma patients. For pediatric patients, use the Pediatric Trauma Score (PTS), which accounts for size, airway, systolic BP, CNS status, wounds, and skeletal injury.
RTS has good predictive accuracy but is not perfect. It predicts survival probability based on large datasets, but individual outcomes vary based on injury patterns, comorbidities, age, time to treatment, and quality of care. Use as a guide, not an absolute predictor.
Use the pre-intubation GCS if available and document it clearly. If only post-intubation assessment is possible, document "intubated" and use the best motor response available. Some systems use a minimum GCS of 3T for intubated patients, but this may underestimate severity.
RTS may underestimate severity in patients with isolated anatomic injuries but stable vitals (e.g., open femur fracture with normal GCS/SBP/RR). Always consider mechanism, anatomic findings, and clinical judgment alongside RTS when making triage decisions.
Calculate RTS at initial assessment, then recalculate with any significant change in patient status. In the pre-hospital setting, reassess every 5-15 minutes. Deteriorating RTS indicates need for more aggressive intervention and possible escalation of care level.