The Pulmonary Score (PS) was developed to measure asthma severity in a child presenting with an acute asthma exacerbation. It can be used to determine the level of therapy required and to evaluate the child's response to interventions.
Parameters:
(1) respiratory rate based on age
(2) wheezing
(3) accessory muscle use (sternocleidomastoid)
Parameter
Finding
Points
respiratory rate
< 6 years of age AND <= 30 breaths per minute
0
< 6 years of age AND 31 - 45 breaths per minute
1
< 6 years of age AND 46 - 60 breaths per minute
2
< 6 years of age AND > 60 breaths per minute
3
>= 6 years of age AND <= 20 breaths per minute
0
>= 6 years of age AND 21 - 35 breaths per minute
1
>= 6 years of age AND 36 - 50 breaths per minute
2
>= 6 years of age AND > 50 breaths per minute
3
wheezing
none
0
on terminal expiration detected while using a stethoscope
1
entire expiration with stethoscope
2
during inspiration and expiration without stethoscope
3
accessory muscle use
no apparent increase
0
mild increase
1
increased
2
maximal activity
3
where:
• In Table 2 a point score of 0 is listed for "< 30" if < 6 years of age and "< 20" if >= 6 years of age, yet 1 point is assigned if 31 or 21 for the same ages respectively, leaving 30 and 20 unassigned. I made the point assignments for <= for both accordingly.
• The sternocleidomastoid muscle is the only respiratory muscle shown to correlate with airway obstruction.
pulmonary score =
= SUM(points for the 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the more severe the asthmatic symptoms.
Performance:
• The scores before and after treatment showed significant correlation with the peak expiratory rate flow (PEFR).
• Inter-rater performance is good.
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