What is the difference between RTS and T-RTS?

The Revised Trauma Score (RTS) uses weighted coefficients for survival prediction. The Triage-RTS (T-RTS) uses unweighted coded values (simple sum of three coded scores) and is used for field triage under START protocols. This calculator computes the weighted RTS for outcome prediction.

Should I bypass the nearest hospital if RTS < 4?

In Australia and the US, patients with RTS < 4 should be transported directly to a designated Major Trauma Centre, even if this adds transport time, provided the patient is haemodynamically salvageable. Follow your local trauma bypass protocol.

How does RTS compare to ISS?

RTS measures physiological derangement at the time of assessment. ISS (Injury Severity Score) measures anatomical injury severity after full clinical assessment or autopsy. They are complementary — RTS is the pre-hospital triage tool; ISS is the retrospective injury severity measure.

Revised Trauma Score (RTS) — Free Paramedics Calculator

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Multi-vehicle collision, two patients. You need to triage priority in 90 seconds before the second ambulance arrives.

Revised Trauma Score (RTS)

Trauma

GCS coded value

Systolic BP coded value

Respiratory rate coded value

RTS = (0.9368×GCS) + (0.7326×SBP) + (0.2908×RR) Maximum score = 7.84 (minor injury) · RTS <4 → trauma centre activation
Field Triage: RTS ≤11 (unweighted) → consider transport to trauma centre.

Reference: Champion HR et al. — Journal of Trauma 1989 (NCBI) · RCSENG ATLS Guidelines

⚕️ Clinical safety: 🇦🇺 Verify with facility drug formulary and senior clinician · Meets AHPRA/ACSQHC standards

1 What this calculator does

Calculates the Revised Trauma Score (RTS) from Glasgow Coma Scale, systolic blood pressure and respiratory rate. Generates a physiological triage score for trauma severity and predicted survival. Higher scores indicate better physiological status.

2 Formula & professional reasoning

RTS = (0.9368 × GCS coded) + (0.7326 × SBP coded) + (0.2908 × RR coded) | Range: 0–7.84

Each parameter is converted to a coded value (0–4) based on clinical thresholds. The weighted formula was derived by Champion et al. from the Major Trauma Outcome Study. An RTS below 4 indicates a severely injured patient with poor predicted survival and identifies those who should be triaged to the highest level trauma centre. The coded (unweighted) sum is used for field triage under START protocols.

3 Worked examples

⚠️ Illustrative example only — not clinical or professional instruction.

Basic

Minor trauma — walking wounded

Given: GCS 15 (coded 4), SBP 130 (coded 4), RR 16 (coded 4)

Working: (0.9368×4)+(0.7326×4)+(0.2908×4) = 3.747+2.930+1.163

Answer: RTS 7.84 — Minimal injury

💡 Field triage: Green. Physiologically normal. Monitor for deterioration.

Standard

Significant head injury

Given: GCS 10 (coded 3), SBP 110 (coded 4), RR 20 (coded 4)

Working: (0.9368×3)+(0.7326×4)+(0.2908×4) = 2.810+2.930+1.163

Answer: RTS 6.90 — Moderate injury

💡 Field triage: Yellow or Red depending on mechanism. Pre-alert trauma team.

Advanced

Critical poly-trauma

Given: GCS 6 (coded 2), SBP 80 (coded 2), RR 6 (coded 1)

Working: (0.9368×2)+(0.7326×2)+(0.2908×1) = 1.874+1.465+0.291

Answer: RTS 3.63 — Critical — highest triage priority

💡 RTS <4: major trauma centre mandatory. Predicted survival ~36%. Immediate transport, pre-alert.

4 Sanity check

RTS 7.84

Physiologically normal — minor triage

All parameters optimal.

RTS 5–7

Moderate injury — urgent

Pre-alert receiving hospital. Trauma team activation likely needed.

RTS 4–5

Severe — major trauma centre

Predicted survival 60–80%. Activate highest level trauma protocol.

RTS < 4

Critical — immediate highest priority

Predicted survival under 50%. Direct to major trauma centre. Bypass closer facilities.

5 Common errors

Error	Cause	Consequence	Fix
Using raw GCS not coded value	Entering 15 instead of coded 4	RTS calculation completely wrong	The calculator applies coding automatically — enter the raw GCS, SBP and RR values
Measuring SBP after fluid bolus	Pre-hospital intervention changes physiology	Score under-estimates injury severity	Record and document the first-contact physiological values — before any intervention
Ignoring RTS when patient is talking	Verbal reassurance reduces perceived urgency	Significant internal injuries missed	A talking patient can still have an RTS below 6 if tachycardic and tachypnoeic
Using RTS as sole triage tool	Over-reliance on a single score	Anatomical injuries missed (penetrating, tension pneumo)	RTS supplements clinical judgement and anatomical assessment — not a replacement