When managing a patient with multiple injuries, it is important to understand how severe each injury is in order to assess the overall severity of the trauma. The Revised Trauma Score (RTS) is one such scoring system that has been shown in numerous studies to be an accurate predictor of mortality and morbidity among trauma patients. It can be used in any patient with multiple injuries who has been triaged into a trauma center. One example of such a situation would be someone who sustained multiple traumas while being transported by an ambulance after having fallen off his bicycle while riding down a hill. In this article, I will briefly go over what makes up the RTS and why its prognostic power trumps other scoring systems like the Injury Severity Score (ISS).
The pathophysiology of trauma
Trauma is a condition that results from an external force that causes injury to the body. The pathophysiology of trauma includes cellular damage, inflammatory response, and coagulopathy. Trauma can cause death or disability; it is one of the leading causes of death in the United States.
Trauma is a leading cause of death worldwide. It is also a leading cause of disability and long-term health problems, especially in children. Trauma can occur as a result of many different types of injuries such as:
- Motor vehicle crashes
- Poisonings (overdoses)
- Combat injuries (war wounds)
Why should we calculate RTS?
The Revised Trauma Score (RTS) is a very popular scoring system used in trauma triage and management to assess the severity of trauma. RTS has been shown to be a predictor of mortality, morbidity, and survival probability in patients with severe injuries.
The RTS was first published in 1990 and its main purpose is to be used as an assessment tool when evaluating patients with multiple injuries. It is only applicable after traumatic injuries, i.e. it cannot be used in other medical emergencies such as heart attack or stroke. For this reason, the Revised Trauma Score (RTS) should not be confused with other scores that predict the mortality of non-trauma patients, such as APACHE II and SOFA scores.
The RTS has three categories: circulation (C), respiration (R), and Glasgow Coma Scale (GCS). Each category is given a score out of two points so that there are six possible points total for each category; however, if the patient does not have any signs of circulation or respiration then those scores do not count towards the total score for their overall results; therefore five categories will be scored whenever possible: C2+R2+GCS4=10 pts
Keep in mind, you should always consult a medical professional before coming to any conlusions.
How to calculate RTS?
To calculate the Revised Trauma Score, add up the number of points for each of the following six variables:
- Systolic Blood Pressure
- Glasgow Coma Scale (GCS)
- Respiratory Rate
This is the simple, clinical score that can be calculated by a trained observer.
Let’s get an example!
Let’s do an example:
You’ve just been admitted to the ER with a gunshot wound to the leg. You’re feeling pretty overwhelmed, but your partner is there to help out. He tells you he’s going to stay with you and asks if he can call anyone for you while the doctors take care of things. You think that would be nice, but then your mind starts racing again as you realize what’s happening here—your partner was shot too! There’s no way he should be here helping out when it’s his own injury that needs attending first. Why didn’t they put him on a gurney instead? That seems like such an obvious thing…
The Revised Trauma Score is made up of three categories: Glasgow Coma Scale, systolic blood pressure, and respiratory rate.
Serious injury to more than one body system.
The ISS is a score that attempts to standardize the severity of injuries sustained during a trauma.