What is the Revised Trauma Score?

The RTS is a physiologic scoring system that combines the Glasgow Coma Scale, systolic blood pressure, and respiratory rate. Each is converted to a coded value from 0 to 4, then weighted and summed to produce a continuous score from 0 to 7.84 used to predict survival in trauma patients.

What are the RTS coding weights?

The weighted RTS uses RTS = 0.9368 × GCS code + 0.7326 × SBP code + 0.2908 × RR code. The Glasgow Coma Scale carries the greatest weight because neurological status is the strongest single predictor of trauma outcome.

What RTS value triggers trauma-centre transfer?

An RTS below 11 on the simpler triage version, or a weighted RTS below roughly 7.55 (any abnormality), is commonly used as a threshold to consider transport to a designated trauma centre. Local protocols vary, so follow your service guidelines.

How does RTS relate to survival probability?

Higher scores correlate with higher survival. A weighted RTS of 7.84 reflects normal physiology and very high survival, while scores below 4 reflect severe derangement and markedly reduced survival. RTS is one input to the combined TRISS methodology.

Is my data stored anywhere?

No. The calculation runs entirely in your browser and nothing you enter is transmitted or saved on any server.

What is the Revised Trauma Score (RTS) Calculator?

Computes the Revised Trauma Score from Glasgow Coma Scale, systolic blood pressure, and respiratory rate, weighting each coded value for survival prediction. Built for paramedics and emergency clinicians scoring major trauma. Runs 100% in your browser. It runs free in your browser on Gera Tools, with nothing uploaded.

Revised Trauma Score (RTS) Calculator

Name: Revised Trauma Score (RTS) Calculator
Creator: Gera Tools
License: https://creativecommons.org/licenses/by/4.0/

The Revised Trauma Score (RTS) turns three bedside physiologic measurements into a single weighted number that predicts how likely a major-trauma patient is to survive. It is widely used in prehospital triage and trauma registries because it needs only the Glasgow Coma Scale, a blood-pressure cuff, and a respiratory count.

How it works

Each of the three variables is first mapped to a coded value from 0 (worst) to 4 (normal):

Glasgow Coma Scale (GCS): 13–15 → 4, 9–12 → 3, 6–8 → 2, 4–5 → 1, 3 → 0.
Systolic blood pressure (SBP, mmHg): greater than 89 → 4, 76–89 → 3, 50–75 → 2, 1–49 → 1, 0 → 0.
Respiratory rate (RR, breaths/min): 10–29 → 4, greater than 29 → 3, 6–9 → 2, 1–5 → 1, 0 → 0.

The coded values are then combined with their published regression weights:

RTS = 0.9368 × GCS_code + 0.7326 × SBP_code + 0.2908 × RR_code

The maximum (entirely normal physiology) is 0.9368×4 + 0.7326×4 + 0.2908×4 = 7.84. The Glasgow Coma Scale is weighted most heavily because neurological status is the single strongest predictor of trauma death.

Why the GCS carries the highest weight

The regression weights in the RTS were derived from the Major Trauma Outcome Study dataset and reflect which physiologic variables most strongly predicted survival. The Glasgow Coma Scale (weight 0.9368) carries roughly three times the weight of respiratory rate (0.2908) because neurological injury is both the most common cause of trauma death and the variable that most strongly discriminates survivors from non-survivors in the dataset.

This has practical triage implications: a patient with a dramatically reduced GCS — even if their blood pressure and respiratory rate are relatively preserved — will have a substantially lower RTS than their other vitals might suggest. The reduced GCS should prompt the same urgency as haemodynamic compromise.

Triage RTS vs weighted RTS

The full weighted RTS described here (using the three regression coefficients) is used for trauma registry analysis, outcome benchmarking, and the TRISS (Trauma and Injury Severity Score) methodology, which combines anatomical and physiologic severity to predict survival probability.

A simpler triage RTS uses the same three variables and the same 0–4 coding, but sums the coded values without weighting (a maximum of 12). An unweighted sum below 11 is commonly used as a prehospital triage criterion for considering direct transport to a trauma centre. Check your local protocols, as thresholds vary by jurisdiction and trauma system.

Worked examples

Example 1 — severely injured patient: A patient with GCS 10 (code 3), SBP 80 mmHg (code 3), and RR 35 breaths/min (code 3):

RTS = 0.9368 × 3 + 0.7326 × 3 + 0.2908 × 3 = 2.8104 + 2.1978 + 0.8724 = 5.88

All three parameters are abnormal. This patient should be evaluated for trauma-centre transport.

Example 2 — normal physiology: GCS 15 (code 4), SBP 120 mmHg (code 4), RR 18 breaths/min (code 4):

RTS = 0.9368 × 4 + 0.7326 × 4 + 0.2908 × 4 = 7.84

Maximum score — all parameters within normal range.

Example 3 — isolated neurological injury: GCS 6 (code 2), SBP 130 mmHg (code 4), RR 16 breaths/min (code 4):

RTS = 0.9368 × 2 + 0.7326 × 4 + 0.2908 × 4 = 1.8736 + 2.9304 + 1.1632 = 5.97

Despite a near-normal blood pressure and respiratory rate, the severe GCS impairment pulls the overall score down to indicate a high-risk patient — illustrating why the GCS component is weighted most heavily.

Confounders to document

The RTS is a triage and audit tool, not a diagnosis. Several confounders can mislead the score:

Intubation — removes the verbal component of GCS and suppresses the respiratory rate variable; document RSI or pre-hospital intubation status
Sedatives and paralytics — reduce GCS and respiratory rate independently of neurological or respiratory injury
Alcohol or drugs — can suppress GCS without trauma to the brain
Hypothermia — may suppress respiratory rate

Always document confounders alongside the score. In a trauma registry context, the pre-intubation GCS is preferred when it can be reliably estimated.