Severity of Asthma Exacerbation
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Mild |
Moderate
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Severe |
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Respiratory Rate
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2-3 yrs: <34/min4-5 yrs: <30/min6-12 yrs: <26/min>12 yrs: <23/min
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2-3 yrs: 35-39/min4-5 yrs: 31-35/min6-12 yrs: 27-30/min>12 yrs: 24-27/min
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2-3 yrs: >40/min4-5 yrs: >36/min6-12 yrs: >31/min>12 yrs: >28/min
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Pulse Oximetry (SpO2) Requirement
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>95% on room air
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90-95% on room air
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<90% on room air
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Auscultation
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Normal or end expiratory wheeze
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Expiratory wheezing
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Inspiratory and expiratory wheeze or diminished breath sounds
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Retractions
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None or intercostal
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Intercostal and substernal
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Intercostal, substernal, and supraclavicular
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Dyspnea
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Speaks in sentences
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Speaks in partial sentences
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Speaks in single words or short phrases
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Patients may not display all signs/symptoms in a single column. Clinical judgment is essential to the assessment of severity.
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Scoring Reference(Mild symptoms = 1; Moderate symptoms = 2; Severe symptoms = 3) |
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Pediatric Asthma Score |
5-7 |
8-11 |
12-15 |
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Kelly CS, Andersen CL, Pestian JP. Improved outcomes for hospitalized asthmatic children using a clinical pathway. Ann Allergy Asthma Immunol. 2000;84(5):509–516
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.