Pediatric Trauma Score (PTS)
Rapid triage tool to summarize pediatric trauma severity using six clinical domains.
Last reviewed: February 26, 2026
Clinical disclaimer
Weight affects the PTS category: >20 kg, 10-20 kg, or <10 kg.
How PTS works
PTS assigns points from -1 to +2 across six categories. The total ranges from -6 to +12, with lower scores indicating higher risk.
- Weight category is a key factor in the score.
- Airway, blood pressure, and CNS status reflect physiologic stability.
- Fractures and wounds capture anatomic injury burden.
Interpretation
- PTS 9-12: lower trauma risk, but still monitor and reassess.
- PTS 8 or less: suggests major trauma and need for higher-level evaluation.
- Lower scores correlate with higher mortality risk.
Thresholds vary by institution and prehospital protocols.
Rapid bedside workflow
- Perform initial trauma ABC assessment and stabilization before formal score documentation.
- Assign each PTS domain from current bedside findings, using the most concerning reliable value.
- Calculate total PTS and classify risk threshold while integrating injury mechanism context.
- Use score to support triage destination and monitoring intensity, not to override unstable exam findings.
- Repeat scoring when clinical status changes or after major interventions.
Reassessment cadence
- After initial scoring in active trauma evaluation: reassess at short interval or after each major intervention.
- During transport or handoff transitions: repeat core vitals/exam domains before transfer decisions.
- If trajectory worsens or data quality is uncertain: immediate repeat scoring and escalation.
Escalation triggers
- PTS at or below major-trauma threshold with concerning physiologic findings.
- Declining neurologic status, airway instability, or hypotension trend regardless of initial score.
- Mismatch between low-risk score and high-risk mechanism or bedside deterioration.
- Need for resources beyond current facility capability.
Shift handoff checklist
- PTS total and component-domain scoring basis (including uncertain elements).
- Trend compared with prior assessment and interval timing.
- Interventions performed and response observed.
- Current escalation threshold and destination/consult plan.
Related calculators
References
Frequently asked questions
PTS summarizes injury severity using weight, airway, systolic blood pressure, neurologic status, fractures, and wounds. Lower scores indicate higher risk.
A PTS of 8 or less is commonly used as a threshold suggesting major trauma and need for higher-level care.
An estimate is acceptable. The score uses broad weight categories: >20 kg, 10-20 kg, and <10 kg.
No. PTS is a rapid triage tool and should be used alongside exam findings, mechanism, and local trauma protocols.
Include total score, domain-level drivers, trend direction, interventions, and escalation plan. A single total without context can miss important deterioration signals.