Pediatric Trauma Score (PTS)

Pediatric Trauma Score Calculator

Weight

Airway

Systolic Blood Pressure

Central Nervous System

Open Wound

Skeletal Injury

Pediatric Trauma Score: –

Score: 12

Default +2 (Normal) for unset items.

Stratifies severity of traumatic injury in children.

Why Use

Helps providers stratify risk of significant injury with high mortality risk. Helps triage patients in a resource-limited environment by identifying children with high mortality risk compared to patients who may not be as critically ill and require fewer resources. May also be used by first responders on scene to help triage patients requiring transfer to a pediatric trauma center vs transfer to a facility that has pediatric providers who can help to provide initial care to trauma patients.

When to Use

Pediatric patients (age <18 years) presenting with trauma. Use with caution in patients with blunt abdominal trauma, as the score is poorly validated in this population. Should not be used to predict isolated injuries.

Formula

Addition of the selected points: Variable Points Weight >20 kg (>44 lbs) 2 10-20 kg (22-44 lbs) 1 <10 kg (<22 lbs) -1 Airway status Normal 2 Maintainable 1 Unmaintainable -1 Systolic BP* >90 mmHg 2 50-90 mmHg 1 <50 mmHg -1 Central nervous system Awake 2 Obtunded/loss of consciousness 1 Coma/decerebrate -1 Skeletal injury None 2 Closed fracture 1 Open/multiple fractures -1 Cutaneous wounds None 2 Minor 1 Major/penetrating -1 *If proper-sized BP cuff not available, BP can be assessed by assigning points as follows: Pulse palpable at wrist 2 Pulse palpable at groin 1 No pulse palpable -1

Pearls / Pitfalls

Best used as a general predictor of stratifying injury severity. Poorly validated in blunt abdominal trauma, specifically to predict isolated injuries such as liver and spleen ( Saladino 1991 ).

Management

After scoring is completed, high risk patients (i.e., low scores) should be triaged for immediate medical attention at a pediatric trauma center if one is nearby, or stabilization at the closest medical facility at the discretion of the first responder. Patients with higher scores are less likely to have significant morbidity and mortality, but require reassessment as symptoms evolve. Evaluation by a physician including a complete history and physical is still recommended.

Critical Actions

Do not forget that reassessment is an essential part of patient care in all interactions. Patients with an initial score indicating morbidity and mortality may have changes in clinical status, and recalculation may be necessary.

Advice

Patient conditions may change after initial assessment and scoring. Patients should continue to be monitored for evolution of signs and symptoms. Should not be used to advise patients that medical attention is not needed after trauma, as a full evaluation by a medical provider is still recommended.

More Information

Interpretation: Higher scores correlate with lower mortality (total scores range from -6 to 12 points). In the original and validation studies, no deaths were seen in patients with scores >8.