Pediatric Trauma Score

The Pediatric Trauma Score (PTS) is a clinical assessment tool specifically designed for evaluating injury severity in pediatric trauma patients. Developed by Tepas et al. in 1987, the PTS addresses the unique physiological and anatomical characteristics of children that make adult trauma scoring systems less applicable to the pediatric population.

Children differ fundamentally from adults in their response to trauma. Their smaller body mass means greater energy transfer per unit area from traumatic forces. Their compliant skeletal structures can transmit forces to internal organs without external fracture evidence. Their physiological reserves allow maintenance of normal vital signs longer before catastrophic decompensation.

The PTS evaluates six clinical components, each scored as +2 (normal), +1 (moderate), or -1 (severe): weight (physiological reserve), airway status (ventilatory function), level of consciousness (neurological function), systolic blood pressure (circulatory status), open wounds (anatomical damage), and skeletal injuries (structural damage).

The total PTS ranges from +12 (best) to -6 (worst). A score of 8 or less identifies children at increased risk, and the ACS recommends transport to a pediatric trauma center. Scores below 0 are associated with mortality rates approaching 100%. The weight component serves as a proxy for physiological reserve and vulnerability unique to pediatric assessment.

The airway assessment categorizes patients as normal (spontaneous ventilation), maintainable (requiring simple adjuncts), or unmaintainable (requiring intubation). This reflects the anatomical differences of the pediatric airway and the severity of underlying injury.

The PTS has been validated in multiple large-scale studies demonstrating strong correlation with the ISS, need for operative intervention, and mortality. Its simplicity makes it valuable in prehospital settings where it can be applied by paramedics without laboratory data.

Each component contributes independently to the total score, and the combination of positive and negative values allows the score to range across a wide spectrum that captures the full range of pediatric trauma severity from minor injuries to immediately life-threatening conditions requiring maximal intervention.

This calculator implements the complete PTS, summing the six component scores and providing a mortality risk classification based on established thresholds validated in the pediatric trauma literature.