The Revised Trauma Score ranges from 0 to 7.8408, with higher scores indicating better physiologic status. A maximum score of 7.84 (all coded values equal to 4) indicates normal GCS, systolic blood pressure, and respiratory rate. Any score below 7.84 means at least one physiologic parameter is compromised. An RTS between 4 and 7.84 indicates moderate physiologic derangement, while an RTS below 4 indicates severe injury with high mortality risk.

The RTS correlates directly with survival probability. An RTS of 7.84 is associated with survival rates above 97%, while an RTS of 4 corresponds to approximately 60% survival, and an RTS of 0 carries near-zero survival probability. These probabilities are further refined when the RTS is combined with the Injury Severity Score (ISS) in the TRISS methodology.

Any score below the maximum should prompt consideration of transport to a designated trauma center, as per the American College of Surgeons field triage guidelines. The weighted scoring emphasizes GCS (consciousness) as the strongest predictor of outcome, followed by blood pressure, with respiratory rate contributing the least weight.

Use the Revised Trauma Score in the prehospital setting for field triage decisions — specifically to determine whether a trauma patient needs to be transported to a Level I or Level II trauma center rather than the nearest hospital. Paramedics and first responders can calculate it rapidly using only three readily available vital signs. An RTS below 7.84 is one of the Step 2 physiologic criteria in the CDC Field Triage Decision Scheme.

The RTS is also used in hospital trauma registries for quality assurance and benchmarking. As part of the TRISS methodology (combining RTS with ISS and patient age), it enables comparison of actual versus expected survival across institutions. Researchers use it in trauma epidemiology studies to standardize injury severity reporting.

The RTS has important limitations in certain patient populations. It may overestimate injury severity in patients who are intoxicated (artificially lowered GCS), intubated and sedated (altered GCS and RR), or on beta-blockers or other medications that blunt physiologic responses. Conversely, it may underestimate severity in young, fit patients who can maintain normal vitals despite significant hemorrhage until sudden decompensation.

The coded scoring system creates broad categories that lose granularity. For example, a GCS of 13 and a GCS of 15 both receive a coded value of 4, despite meaningful clinical differences. Similarly, the SBP category treats all values above 89 mmHg equally, missing the prognostic difference between an SBP of 90 and 140.

The RTS does not incorporate mechanism of injury, anatomic injury pattern, or patient comorbidities, all of which significantly affect outcomes. It should be used as one component of a comprehensive triage assessment, not as a sole decision-making tool. Pediatric patients require age-adjusted vital sign parameters that the standard RTS does not provide.