Revised Trauma Score Worksheet

What is the Revised Trauma Score system?

The Revised Trauma Score (RTS) system is a medical scoring system used to assess the severity of a traumatic injury and predict the likelihood of a patient's survival. It combines physiological measurements to create a score that helps healthcare providers make quick, accurate decisions in trauma situations. The RTS is commonly used in emergency medical services (EMS) and trauma centers to triage patients and prioritize treatment based on the severity of their injuries.

The RTS system includes three main parameters:

1. Glasgow Coma Scale (GCS): This measures a patient's level of consciousness, assessing eye, verbal, and motor responses. The GCS score ranges from 3 to 15, with lower scores indicating more severe impairment.
2. Systolic Blood Pressure (SBP): This measures the pressure in the arteries when the heart beats. It indicates a patient's circulatory status and overall physiological stability.
3. Respiratory Rate (RR): This measures the number of breaths a patient takes per minute, reflecting the patient's respiratory function and oxygenation status.

Each of these parameters is assigned a score, and the total RTS is calculated by summing the weighted values of these scores. The RTS ranges from 0 to 12, with higher scores indicating less severe trauma and a better prognosis. The system is valued for its simplicity, ease of use, and ability to convey critical information about a patient's condition quickly.

What are the scores used in trauma?

In trauma care, several scoring systems are used to evaluate the severity of injuries and predict patient outcomes. These scores help make informed decisions regarding patient management, resource allocation, and treatment priorities. The main scores used in trauma include:

1. Glasgow Coma Scale: The GCS assesses a patient's level of consciousness based on eye, verbal, and motor responses. Scores range from 3 (deep unconsciousness) to 15 (fully awake). It is widely used to evaluate brain injuries.
2. Revised Trauma Score: As described above, the RTS combines the GCS, systolic blood pressure, and respiratory rate to assess the overall severity of trauma. Scores range from 0 to 12, with higher scores indicating better physiological status.
3. Injury Severity Score: The ISS quantifies overall injury severity based on the Abbreviated Injury Scale (AIS) for different body regions. It ranges from 0 to 75, with higher scores indicating more severe injuries. The ISS is particularly useful for assessing patients with multiple injuries.
4. Trauma and Injury Severity Score: The TRISS combines the RTS, ISS, and patient age to predict survival probability. It compares trauma care quality across different institutions and researches trauma outcomes.
5. Abbreviated Injury Scale (AIS): The AIS provides a standardized method for coding the severity of individual injuries for different body regions. It ranges from 1 (minor) to 6 (unsurvivable). The AIS is critical to the ISS and other composite trauma scores.
6. Pediatric Trauma Score (PTS): The PTS is specifically designed to assess children's trauma severity. It includes parameters such as weight, airway status, systolic blood pressure, central nervous system status, open wounds, and skeletal injuries. Scores range from -6 to +12, with higher scores indicating less severe trauma.
7. New Injury Severity Score (NISS): The NISS is a modification of the ISS that considers the three most severe injuries regardless of body region. It provides a more comprehensive assessment of overall injury severity.

These trauma scoring systems are essential tools in emergency and trauma care. They enable healthcare providers to quickly assess injury severity, predict outcomes, and optimize patient management.

Benefits of Revised Trauma Scores for chronic health evaluation

Revised Trauma Scores are commonly used in acute care settings to assess the severity of trauma patients. However, their application extends beyond initial assessment, offering valuable insights into chronic health evaluation.

Comprehensive patient assessment

One of the primary benefits of incorporating RTS into chronic health evaluation is the ability to comprehensively assess a patient's health trajectory. RTS considers various physiological parameters such as GCS, SBP, and RR. By including these parameters, healthcare providers can gain a holistic understanding of the patient's overall health status, which is crucial for managing chronic conditions effectively.

Long-term outcome prediction

RTS provides valuable information for predicting long-term outcomes following traumatic events. Research has shown that initial trauma severity, as indicated by RTS, correlates with subsequent morbidity and mortality rates. By monitoring changes in RTS over time, healthcare providers can identify patients at higher risk of developing chronic health issues and implement appropriate interventions to mitigate these risks.

Monitoring progress and response to treatment

Using RTS in chronic health evaluation allows healthcare providers to monitor patients' progress and assess their response to treatment interventions. By tracking changes in RTS values, clinicians can gauge the effectiveness of therapeutic interventions and adjust treatment plans accordingly. For example, if a patient's RTS improves over time, it may indicate a positive response to treatment, whereas a decline in RTS may prompt a reevaluation of the treatment approach.

Risk stratification

RTS can serve as a useful tool for risk stratification in chronic disease management. By categorizing patients into different risk groups based on their RTS values, healthcare providers can prioritize resource allocation and tailor interventions to meet the specific needs of each group. Patients with lower RTS scores may require more intensive monitoring and intervention, while those with higher RTS scores may benefit from less intensive management strategies.

Early identification of complications

Incorporating RTS into chronic health evaluation enables early identification of complications that may arise as a result of traumatic injuries. Patients with lower RTS scores are at higher risk of developing complications such as infections, organ dysfunction, and impaired mobility. By regularly assessing RTS values, healthcare providers can promptly detect signs of deterioration and intervene to prevent further complications from occurring.

Improved communication and care coordination

Utilizing RTS in chronic health evaluation promotes improved communication and care coordination among multidisciplinary healthcare teams. RTS provides a standardized framework for assessing and documenting patients' clinical status, facilitating clearer communication among healthcare providers. This, in turn, enhances collaboration and ensures that patients receive timely and appropriate care throughout their continuum of care.

Research and quality improvement

Lastly, incorporating RTS into chronic health evaluation supports research efforts to improve outcomes for trauma patients. Researchers can identify trends, patterns, and prognostic factors associated with long-term health outcomes by analyzing RTS data collected over time. This information can inform the development of evidence-based interventions and quality improvement initiatives aimed at optimizing patient care and enhancing long-term health outcomes.

How to calculate RTS using our worksheet?

Calculating the RTS using our worksheet is straightforward. To begin, gather the patient's GCS score, SBP score, and RR score. These three parameters are needed in determining the patient's physiological state. Once you have these values, the worksheet guides you in assigning the appropriate scores for each parameter based on standardized scales.

After assigning the scores, use the following formula to calculate the RTS: RTS = (0.9368 x GCS score) + (0.7326 x SBP score) + (0.2908 x RR Score). This composite score, ranging from 0 to 12, provides quantifiable measure of trauma severity that aids in quick and accurate clinical decision-making.