II. Indications
- Asthma Exacerbation in Children (age 2 years and older)
III. Criteria (five components, each scored 1 to 3)
-
Respiratory Rate
- Age 2 to 3 years
- Score 1: <=34 breaths/min
- Score 2: 35-39 breaths/min
- Score 3: >=40 breaths/min
- Age 4 to 5 years
- Score 1: <=30 breaths/min
- Score 2: 31-35 breaths/min
- Score 3: >=36 breaths/min
- Age 6 to 12 years
- Score 1: <=26 breaths/min
- Score 2: 27-30 breaths/min
- Score 3: >=31 breaths/min
- Age >12 years
- Score 1: <=23 breaths/min
- Score 2: 24-27 breaths/min
- Score 3: >=28 breaths/min
- Age 2 to 3 years
- Oxygen Requirement (O2 Sat)
- Score 1: >95% on room air
- Score 2: 90 to 95% on room air
- Score 3: <90% on room air or Supplemental Oxygen
- Auscultation
- Score 1: Normal breath sounds (or end-Expiratory Wheezing only)
- Score 2: Expiratory Wheezing
- Score 3: Inspiratory and Expiratory Wheezing (or diminished breath sounds)
- Retractions
- Score 1: No retractions or intercostal retractions only
- Score 2: Intercostal and substernal retractions
- Score 3: Intercostal, Subcostal and Supraclavicular Retractions
-
Dyspnea
- Score 1: Speaks in full sentences (or coos or babbles)
- Score 2: Speaks in partial sentences (or short cries)
- Score 3: Speaks in single words or short phrases (or grunts)
IV. Interpretation
- Total Score 5 to 7: Mild Asthma Exacerbation
- Predicted Peak Flow: >70%
- Total Score 8 to 11: Moderate Asthma Exacerbation
- Predicted Peak Flow: 50 to 70%
- Total Score 12 to 15: Severe Asthma Exacerbation (or Status Asthmaticus)
- Predicted Peak Flow: <50%