Revised Trauma Score

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

The Revised Trauma Score (RTS) is a tool for on-site triage for Multiple Casualty Incidents. Its superior efficiency is due to both speed and objectivity. It is designed to provide a comprehensive assessment for medical professionals of any field.

RTS and Triage

The Revised Trauma Score is made up of a combination of results from three categories: Glasgow Coma Scale, systolic blood pressure, and respiratory rate. All of these results can be quickly assessed with minimal equipment: a flashlight, a watch and a sphygmomanometer since systolic pressure can be obtained through arterial palpation. The score range is 0-12. In START triage, a patient with a RTS score of 12 is labeled DELAYED (walking wounded), 11 is URGENT (intervention is required but the patient can wait a short time, and 10-3 is IMMEDIATE (immediate intervention is necessary). The last possible label is MORGUE, which is given to seriously injured people with a RTS score of 3 or lower. These people should not receive certain care because they are unlikely to survive. This clearly has an ethical implication as treatment is intentionally withheld from some people. The reasoning is that diverting scarce resources away from people with a little chance of survival increases the chances of survival of others who are inherently more likely to survive.

Scoring

The score ranges from 0-12.

GCS

GCS .... Points
15-13 ....... 4
12-9 ........ 3
8-6 .......... 2
5-4 .......... 1
3 ............ 0

Systolic Pressure

SBP .... Points
>89 .......... 4
76-89 ....... 3
50-75........ 2
1-49 ......... 1
0 ............. 0

Respiratory Rate

RR ..... Points
29-10 ....... 4
>29 ......... 3
6-9 ......... 2
1-5 ......... 1
0 ............ 0