Pardee et al identified clinical signs associated with respiratory failure, independent of spirometric or laboratory measures. This can help identify patients with respiratory failure likely to need mechanical ventilation, or else patients on mechanical ventilation requiring continued ventilatory support. The authors were from the Mason Clinic in Seattle.
Parameters:
(1) pulse
(2) respiratory rate
(3) scalene muscles during inspiration
(4) abdominal muscles during expiration
(5) respiratory rhythm and apneic episodes
(6) ability to respond appropriately to commands
|
Parameter |
Finding |
Points |
|
pulse |
< 70 beats per minute |
1 |
|
|
70 – 120 beats per minute |
0 |
|
|
> 120 beats per minute |
1 |
|
respiratory rate |
<= 30 |
0 |
|
|
> 30 |
1 |
|
scalene muscles during inspiration |
palpable recruitment present |
1 |
|
|
absent |
0 |
|
abdominal muscles in expiration |
palpable tensing present |
1 |
|
|
absent |
0 |
|
respiratory rhythm and apneic episodes |
irregular irregularity in rhythm AND apneic pauses of varying duration |
1 |
|
|
absent |
0 |
|
mental status |
coma or any condition preventing the patient from responding appropriately to commands |
1 |
|
|
able to respond to commands appropriately |
0 |
number of clinical signs =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score, the more likely that the patient will require respiratory support or die.
|
Clinical Score |
Need Ventilatory Support or Die |
|
0 |
10% |
|
1 or 2 |
50% |
|
3, 4, 5 or 6 |
100% |
Limitations:
• The score was formulated in 1984.
Specialty: Pulmonology
