Pediatric Trauma Score Calculator

Pediatric Trauma Score Calculator for Pediatrics. In the original Tepas validation, PTS correlated inversely and near-linearly with the Injury Severity Score, and three mortality bands emerged: a score above 8 carried 0% mortality, scores between 0 and 8 showed mortality that rose steeply as the score fell, and scores below 0 carried 100% mortality in that cohort. The operational cutoff is 8: children scoring 8 or below should be triaged to a designated pediatric trauma facility, because this threshold captured essentially all patients with potentially major injury. In practice a lower score should escalate urgency of transport, trauma-team activation, and readiness for airway and hemodynamic intervention.

How this calculator works

The Pediatric Trauma Score (PTS) sums six weighted components, each scored +2, +1, or -1, for a total range of -6 to +12. The six domains are body weight (over 20 kg, 10-20 kg, under 10 kg), airway status (normal, oral/nasal airway or oxygen, intubated/cricothyroidotomy), systolic blood pressure (over 90 mmHg, 50-90 mmHg, under 50 mmHg), central nervous system status (awake, obtunded/loss of consciousness, comatose/decerebrate), open wounds (none, minor, major/penetrating), and skeletal injury (none, closed fracture, open/multiple fractures). A higher total reflects greater physiologic reserve and lower injury burden. The size and airway components were deliberately built in to capture the anatomic and physiologic vulnerability specific to children.

When to use this calculator

Use the PTS during prehospital and emergency department triage of an injured child (roughly infancy to adolescence, up to ~14 years or under ~50 kg) to decide who warrants transfer to or activation of a pediatric trauma center. It functions as a rapid, bedside field-triage aid rather than a definitive anatomic severity index. It should not be used to triage adults, and it does not replace formal anatomic scoring (Injury Severity Score) for outcome adjudication, registry benchmarking, or research endpoints. It also should not be used as the sole gatekeeper to deny transfer when clinical judgment or mechanism suggests high risk.

Inputs used

  • Weight
  • Airway
  • Systolic blood pressure
  • Level of consciousness
  • Fractures
  • Wounds

Clinical interpretation

In the original Tepas validation, PTS correlated inversely and near-linearly with the Injury Severity Score, and three mortality bands emerged: a score above 8 carried 0% mortality, scores between 0 and 8 showed mortality that rose steeply as the score fell, and scores below 0 carried 100% mortality in that cohort. The operational cutoff is 8: children scoring 8 or below should be triaged to a designated pediatric trauma facility, because this threshold captured essentially all patients with potentially major injury. In practice a lower score should escalate urgency of transport, trauma-team activation, and readiness for airway and hemodynamic intervention.

Worked example

A 6-year-old struck by a car weighs 22 kg (over 20 kg, +2), maintains her own airway (+2), has a systolic BP of 80 mmHg (50-90 mmHg, +1), is obtunded but responsive (+1), has a large scalp laceration (major wound, -1), and has a closed femur fracture (+1). Total = 2 + 2 + 1 + 1 - 1 + 1 = +6. A PTS of 6 falls at or below the classic threshold of 8, so despite a reassuring general appearance she meets criteria for triage to a pediatric trauma center, and her score in the 0-8 range flags meaningful mortality risk that scales downward with the score.

Limitations and safety notes

The PTS was derived and validated in the 1980s National Pediatric Trauma Registry, so its mortality figures reflect that era's care and are not contemporary predictions. Later comparative studies found it offers little advantage over the simpler Revised Trauma Score or age-adjusted vital signs, and the weight and blood-pressure components require data (an accurate weight, a reliable pediatric cuff BP) that are often unavailable or imprecise in the field, introducing scoring variability. It performs less reliably in infants and can under-triage children who compensate physiologically before decompensating, so a normal or high score never rules out serious occult injury.

Frequently asked questions

What PTS score means a child should go to a pediatric trauma center?

A total of 8 or below is the accepted triage threshold for transfer to or activation of a designated pediatric trauma center. Scores above 8 were associated with 0% mortality in the original cohort, while the 0-to-8 range carries mortality that increases as the score drops.

What is the range of possible scores?

Each of the six components scores +2, +1, or -1, giving a total from -6 to +12. Higher totals indicate greater physiologic reserve and lower injury severity; negative totals indicate life-threatening injury.

How is the PTS different from the Revised Trauma Score?

The PTS adds pediatric-specific domains, most notably body weight/size and airway status, to capture children's anatomic vulnerability, whereas the RTS uses Glasgow Coma Scale, systolic BP, and respiratory rate. Head-to-head studies have not shown the PTS to consistently outperform the RTS for triage.

Can I use the PTS for adults or teenagers?

No. It was derived and validated in children and is intended for the pediatric age range (roughly up to early adolescence or under about 50 kg). Adult and older-adolescent triage should rely on adult physiologic triage tools.

Does a reassuring PTS rule out serious injury?

No. Children can compensate and maintain vital signs before abruptly decompensating, so a normal or high score does not exclude significant occult injury. The score supplements, but does not replace, serial clinical assessment and mechanism-based judgment.

References

  • Tepas JJ, Ramenofsky ML, Mollitt DL, Gans BM, DiScala C. The Pediatric Trauma Score as a predictor of injury severity: an objective assessment. J Trauma. 1988. PMID: 3352003.
  • Tepas JJ, Mollitt DL, Talbert JL, Bryant M. The pediatric trauma score as a predictor of injury severity in the injured child. J Pediatr Surg. 1987. PMID: 3102714.

Editorial review and citation methodology

Reviewed by the Quick Medical Calculator Editorial Team. Last reviewed: June 17, 2026. The review checks calculator inputs, intended population, interpretation, limitations, and source alignment.

  • Prefer original validation studies for scoring systems and prediction tools.
  • Use current specialty society guidance, transplant allocation policy, public health guidance, or regulator resources when they govern clinical use.
  • Include limitations and safety notes when a calculator is population-specific, context-dependent, or unsuitable as a standalone decision tool.

Related reviewed calculators