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    Pediatric Trauma Score (PTS)

    Stratifies severity of traumatic injury in children.
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    INSTRUCTIONS

    Use in pediatric patients (age <18 years) presenting with trauma. Poorly validated in blunt abdominal trauma.

    When to Use
    Pearls/Pitfalls
    Why 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.

    • 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).

    • 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.

    >20 kg (>44 lbs)
    +2
    10-20 kg (22-44 lbs)
    +1
    <10 kg (<22 lbs)
    -1
    Normal
    +2
    Maintainable
    +1
    Unmaintainable
    -1
    >90 mmHg (or pulse palpable at wrist)
    +2
    50-90 mmHg (or pulse palpable at groin)
    +1
    <50 mmHg (or no pulse palpable)
    -1
    Awake
    +2
    Obtunded/loss of consciousness
    +1
    Coma/decerebrate
    -1
    None
    +2
    Closed fracture
    +1
    Open/multiple fractures
    -1
    None
    +2
    Minor
    +1
    Major/penetrating
    -1

    Result:

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    Next Steps
    Evidence
    Creator Insights

    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.

    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.

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    About the Creator
    Dr. Joseph J. Tepas
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