Lowell et al evaluated pediatric patients with respiratory distress using the Respiratory Distress Assessment Instrument (RDAI). This can help evaluate the improvement of the patient to different interventions. The authors are from Yale University.
Parameters:
(1) wheezing on expiration
(2) wheezing on inspiration
(3) location of wheezing
(4) supraclavicular retractions
(5) intercostal retractions
(6) subcostal retractions
|
Parameter |
Finding |
Points |
|
wheezing on expiration |
none |
0 |
|
|
at end |
1 |
|
|
half |
2 |
|
|
three quarters |
3 |
|
|
all of expiration |
4 |
|
wheezing on inspiration |
none |
0 |
|
|
part |
1 |
|
|
all of inspiration |
2 |
|
location of wheezing |
none |
0 |
|
|
1 or 2 of the 4 lung fields |
1 |
|
|
3 or 4 of the 4 lung fields |
2 |
|
supraclavicular retractions |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
|
intercostal retractions |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
|
subcostal retractions |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
subscore for wheezing =
= SUM(points for the first 3 parameters)
subscore for retractions =
= SUM(points for the last 3 parameters)
total RDAI score =
= SUM(points for all 6 parameters)
points for change in respiratory rate =
= ROUND (((initial) - (current)) / (initial),1) * 10
respiratory assessment change score = RACS =
= (previous RDAI score) - (current RDAI score) + (points for change in respiratory rate)
Interpretation:
• minimum subscore: 0
• minimum total RDAI score: 0
• maximum wheezing subscore: 8
• maximum retractions subscore: 9
• maximum total RDAI score: 17
• A RACS >=4 indicates clinical improvement following therapy.
• A RACS < 4 indicates no improvement.
Specialty: Pulmonology, Pedatrics
