Children with status asthmaticus can be assessed for clinical severity, which can be used to guide management.
Parameters:
(1) cyanosis or PaO2
(2) respiratory breath sounds
(3) use of accessory muscles
(4) expiratory wheezing
(5) cerebral function
|
Parameter |
Finding |
Score |
|---|---|---|
|
inspiratory breath sounds |
normal |
0 |
|
|
unequal |
1 |
|
|
decreased to absent |
2 |
|
use of accessory muscles |
none |
0 |
|
|
moderate |
1 |
|
|
maximal |
2 |
|
expiratory wheezing |
none |
0 |
|
|
moderate |
1 |
|
|
marked |
2 |
|
cerebral function |
normal |
0 |
|
|
depressed |
1 |
|
|
agitated |
1 |
|
|
in coma |
2 |
The original score of Wood et al used PaO2 measurement.
|
Parameter |
Finding |
Score |
|---|---|---|
|
PaO2 in mm Hg |
70 - 100 mm Hg on room air |
0 |
|
|
<= 70 mm Hg on room air (FIO2 0.21) |
1 |
|
|
<= 70 mm Hg on 40% oxygen (FIO2 0.40) |
2 |
In the modification by Downes and Raphaely, cyanosis was used instead of PaO2:
|
Parameter |
Finding |
Score |
|---|---|---|
|
cyanosis |
none |
0 |
|
|
on room air |
1 |
|
|
on 40% oxygen |
2 |
In the version given by Hollman et al, mild use of accessory muscles and mild expiratory wheezing were both scored at 0.5 points.
Interpretation:
• minimum score: 0
• maximum score: 10
• The scores correlates directly with PaCO2 and inversely with PaO2 on room air.
|
Asthma Score |
PaCO2 in mm Hg |
Risk of Respiratory Failure |
|---|---|---|
|
< 5 |
< 55 |
low risk |
|
5 - 7 |
55 - 75 |
moderate risk |
|
>= 7 |
>= 75 |
high risk |
Purpose: To clinically assess children with status asthmaticus for the severity of their symptoms.
Specialty: Pulmonology
Objective: severity, prognosis, stage
ICD-10: J45,
