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patients who may be at increased risk for respiratory, circulatory, or neurologic failure
when they present to triage.
Beyond ESI, additional physiologic scoring systems designed specifically for
trauma patients are used to identify children most at risk for major morbidity or death
due to injury. The most useful of these scoring systems are the Glasgow Coma Scale
(GCS) (see Table 7.2 ), the Trauma Score (TS, which includes GCS), and the
Pediatric Trauma Score (PTS) (see Table 7.3 ). Prehospital triage or transfer to a
designated pediatric trauma center is indicated in any patient with a GCS <12 or a
PTS <8.