Measuring how badly an injury affects the body
After a crash, fall or assault, rescuers and trauma teams need a quick way to judge how much the injuries are disturbing vital functions. The Revised Trauma Score (RTS), published by Howard Champion and colleagues in 1989, uses three measurements taken on arrival: consciousness, blood pressure and breathing.
Coding the vital signs
| Code | Glasgow Coma Scale | Systolic BP (mmHg) | Respiratory rate (/min) |
|---|---|---|---|
| 4 | 13–15 | above 89 | 10–29 |
| 3 | 9–12 | 76–89 | above 29 |
| 2 | 6–8 | 50–75 | 6–9 |
| 1 | 4–5 | 1–49 | 1–5 |
| 0 | 3 | 0 | 0 |
Two versions of the score
- Revised Trauma Score: RTS = 0.9368 × GCS code + 0.7326 × SBP code + 0.2908 × RR code. It ranges from 0 to 7.8408. The weights come from survival data, so consciousness counts most.
- Triage RTS (T-RTS): the plain sum of the three codes, from 0 to 12, simple enough to work out in the field.
Worked example
A motorcyclist is confused but opens their eyes and obeys commands (GCS 13), has a systolic blood pressure of 85 mmHg and breathes 32 times a minute:
- Codes: GCS 4, blood pressure 3, respiratory rate 3.
- RTS = 0.9368 × 4 + 0.7326 × 3 + 0.2908 × 3 = 6.8174.
- T-RTS = 4 + 3 + 3 = 10, below 11, which suggests taking the patient to a trauma center.
How it is used
- Field triage: a T-RTS below 11 was proposed as a trigger for trauma center transport. Current US field triage guidelines use a broader set of criteria, including abnormal vital signs, specific injuries such as penetrating wounds to the torso, and the mechanism of injury.
- Outcome research: in the TRISS method, the RTS is combined with the anatomical Injury Severity Score and age to estimate each patient’s probability of survival. Trauma registries compare actual and expected survival to evaluate quality of care.
- Monitoring: repeated scores show whether a patient is improving or deteriorating.
Limits
The RTS reflects physiology at one moment. A young, fit patient can keep a normal blood pressure while bleeding internally until they suddenly collapse, and drugs, alcohol or sedation lower the GCS without brain injury. Intubated patients cannot be scored normally for breathing and speech. The score supports, and never replaces, clinical assessment, imaging and repeated examination.
This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.