π Revised Trauma Score
Physiologic triage scoring for trauma.
For informational purposes only, not medical advice. Consult a healthcare professional.
The Revised Trauma Score compresses the three vital physiologic variables, consciousness, blood pressure, and breathing, into one triage number. Each is coded 0 to 4 and weighted: GCS counts most at 0.9368, then systolic pressure at 0.7326, then respiratory rate at 0.2908, for a maximum of 7.84. Developed by Champion and colleagues, it became the physiologic half of TRISS and a standard for field triage and trauma audit. This calculator applies the weights for teaching and reference.
How to Use This Calculator
Select the coded value (0 to 4) for each of the three physiologic variables. The calculator applies the RTS weights.
Code each variable 0 to 4 using the ranges shown: GCS, systolic blood pressure, and respiratory rate.
Read the weighted RTS from 0 to 7.84. Higher is better; 7.84 is a fully normal set of vitals.
Use it for triage and audit. RTS under 4 historically flagged high mortality and trauma-center triage.
How the Math Works
Multiply each coded value by its weight and sum: 0.9368 times GCS code plus 0.7326 times SBP code plus 0.2908 times RR code. A fully normal patient scores 0.9368 times 4 plus 0.7326 times 4 plus 0.2908 times 4, which is 7.8408, conventionally 7.84. The weights came from logistic regression on trauma outcomes, which is why consciousness dominates: brain injury drives early trauma mortality. An RTS under 4 was the classic field triage trigger for trauma-center transport, and the score feeds survival probability calculations in trauma registries.
Worked Example
A trauma patient with GCS 14, systolic 120, and respiratory rate 18 codes 4-4-4, giving an RTS of 7.84. That is the maximum: normal physiology across all three variables. Drop the GCS code to 2 and the systolic code to 2, and the score falls to about 4.4, crossing into the range where trauma-center triage criteria start firing.
Reading Your Result
Near 7.84 means physiologically intact; minor trauma management applies. The 4 to 7 band is abnormal physiology needing trauma evaluation, with lower values meaning sicker patients. Under 4 marks severe physiologic derangement with historically high mortality, triggering the highest level of trauma response. RTS describes physiology at one moment; repeat it, because trauma physiology moves fast.
| RTS | Meaning | Action |
|---|---|---|
| 7.84 | Normal physiology | Routine trauma assessment |
| 4-7 | Abnormal | Trauma evaluation |
| Under 4 | Severe derangement | Highest-level trauma response |
Limitations
RTS captures physiology, not anatomy: a severe isolated injury with normal vitals scores perfectly. Intubation, sedation, and paralysis invalidate the GCS and RR components. It was derived decades ago and triage systems have evolved, though the score remains an audit standard. Field use requires training; the number never replaces the primary survey.
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For informational purposes only, not medical advice. Consult a healthcare professional.
Frequently Asked Questions
What is the Revised Trauma Score?
A physiologic trauma score from coded GCS, systolic blood pressure, and respiratory rate, weighted 0.9368, 0.7326, and 0.2908 for a 0 to 7.84 range. Developed by Champion et al., it is used for field triage, emergency assessment, and trauma registry audit.
How do you code the variables?
GCS 13-15 scores 4, 9-12 scores 3, 6-8 scores 2, 4-5 scores 1, 3 scores 0. SBP over 89 scores 4, 76-89 scores 3, 50-75 scores 2, 1-49 scores 1, 0 scores 0. RR 10-29 scores 4, over 29 scores 3, 6-9 scores 2, 1-5 scores 1, 0 scores 0.
What RTS triggers trauma-center transport?
Historically under 4, combined with anatomic and mechanism criteria in field triage schemes. Modern triage uses the full CDC field triage guidelines, where physiologic criteria are just the first step. Local protocols rule.
What is TRISS?
Trauma and Injury Severity Score: combines RTS (physiology), ISS (anatomy), and age into a survival probability. RTS is the physiologic half. TRISS remains a registry standard for benchmarking trauma center outcomes.
Why does GCS get the biggest weight?
Because in the derivation data, neurologic status predicted survival more strongly than blood pressure or breathing. The weights are empirical from logistic regression, not chosen by intuition. Brain injury dominates early trauma death.
Can RTS be used in children?
With caution. Pediatric vital-sign norms differ, and pediatric-specific scores exist. Adult-coded RTS misclassifies children, especially for respiratory rate and blood pressure. Use pediatric triage tools for kids.
What is the maximum RTS?
7.84, from coded 4s across all three variables. It represents normal physiology, not zero injury: anatomy can still be badly hurt. The minimum 0 means no measurable GCS, pressure, or breathing.
Does intubation affect RTS?
Yes, profoundly: intubated patients get a verbal GCS of 1 by convention and their respiratory rate reflects the ventilator. Score before intubation when possible, and note the airway status alongside any post-intubation score.
How does RTS differ from ISS?
RTS measures physiology right now; ISS measures anatomic injury severity from the full diagnosis list. A patient can have a perfect RTS with a terrible ISS, like a contained major fracture pattern, or a terrible RTS with modest ISS, like early shock. They complement each other.
Is RTS still used today?
Yes, in trauma registries, audit, and research, and its components live on in triage criteria. Prehospital systems increasingly use simpler physiologic triggers, but RTS remains the common language for comparing trauma populations.