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Revised Trauma Score

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The Revised Trauma Score (RTS) is a physiologic scoring system, designed for use in based on the initial vital signs of a patient.[1] A lower score indicates a higher severity of injury.[2]

Use in triage

The Revised Trauma Score is made up of a three categories: Glasgow Coma Scale, Systolic blood pressure, and respiratory rate. The score range is 0-12. In START triage, a patient with an RTS score of 12 is labeled delayed, 11 is urgent, and 3-10 is immediate. Those who have an RTS below 3 are declared dead and should not receive certain care because they are highly unlikely to survive without a significant amount of resources.[citation needed]

Scoring

The score is as follows:[3]

Glasgow Coma Scale
GCS Points
15-13 4
12-9 3
8-6 2
5-4 1
3 0
Systolic Blood Pressure
SBP Points
>89 4
76-89 3
50-75 2
1-49 1
0 0
Respiratory Rate
RR Points
10-29 4
>29 3
6-9 2
1-5 1
0 0

These three scores (Glasgow Coma Scale, Systolic Blood, Pressure Respiratory) are then used to take the weighted sum by RTS = 0.9368 GCS + 0.7326 SBP + 0.2908 RR. Values for the RTS are in the range 0 to 7.8408. The RTS is heavily weighted towards the Glasgow Coma Scale to compensate for major head injury without multisystem injury or major physiological changes. A threshold of RTS < 4 has been proposed to identify those patients who should be treated in a trauma centre, although this value may be somewhat low.

References

  1. ^ Champion HR, Sacco WJ, Carnazzo AJ, Copes W, Fouty WJ (September 1981). "Trauma score". Crit. Care Med. 9 (9): 672–6. doi:10.1097/00003246-198109000-00015. PMID 7273818.
  2. ^ Taber, Clarence Wilbur; Venes, Donald (2009). Taber's cyclopedic medical dictionary. F a Davis Co. p. 2366. ISBN 0-8036-1559-0.
  3. ^ Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME (May 1989). "A revision of the Trauma Score". The Journal of Trauma. 29 (5): 623–9. doi:10.1097/00005373-198905000-00017. PMID 2657085.