Revised Trauma Score

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.

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

↑ 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.
↑ Taber, Clarence Wilbur; Venes, Donald (2009). Taber's cyclopedic medical dictionary. F a Davis Co. p. 2366. ISBN 0-8036-1559-0.
↑ 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.

Trauma

Principles

Assessment

Clinical prediction rules	Revised Trauma Score Injury Severity Score Abbreviated Injury Scale NACA score

Investigations	Diagnostic peritoneal lavage Focused assessment with sonography for trauma

Management

Principles	Advanced trauma life support Trauma surgery Trauma center Trauma team Damage control surgery Early appropriate care

Procedures	Resuscitative thoracotomy

Pathophysiology

Injury	MSK Bone fracture Joint dislocation Degloving Soft tissue injury Resp Flail chest Pneumothorax Hemothorax Diaphragmatic rupture Pulmonary contusion Cardio Internal bleeding Thoracic aorta injury Cardiac tamponade GI Blunt kidney trauma Ruptured spleen Neuro Penetrating head injury Traumatic brain injury Intracranial hemorrhage

Mechanism	Blast injury Blunt trauma Burn Penetrating trauma Crush injury Stab wound Ballistic trauma Electrocution

Region	Abdominal trauma Chest trauma Facial trauma Head injury Spinal cord injury

Demographic	Geriatric trauma Pediatric trauma

Complications

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