Shutes et al reported the Airway Clearance and Expansion Index (ACE-I) to help to identify a pediatric patient with respiratory distress who may have difficulty clearing the airway. Such a patient may benefit from respiratory therapy. The authors are from Nationwide Children's Hospital and the Ohio State University.
Patient selection: pediatric patient with respiratory distress
Parameters:
(1) secretions
(2) chest radiograph (<= 48 hours)
(3) cough quality
(4) breath sounds
Parameter
Finding
Points
secretions
none to scant
0
moderate, easily mobile
1
moderate thick or copious thin
2
thick and copious
3
chest radiograph
no atelectasis or volume loss
0
scattered atelectasis
1
lobar atelectasis or consolidation
2
cough quality
good with care alone
0
good with suction
1
poor with suction
2
none or paralyzed
3
breath sounds
clear
0
scattered crackles that clear
1
coarse, clears with cough or suctioning
2
coarse do not clear with cough or suctioning
3
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
• The higher the score the greater the impairment in airway clearance and the greater the need for respiratory therapy.
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