Liu et al reported the Respiratory Clinical Score for evaluating pediatric patients with asthma. The authors are from the University of Washington in Seattle, the New Mexico Department of Health, University of Michigan and Children's Hospital and Regional Medical Center in Seattle.
Patient selection: o through 4 years of age with asthma
Parameters:
(1) respiratory rate in breaths per minute by age
(2) muscle retractions
(3) dyspnea based on number counted on one breath
(4) auscultation
Age
Respiratory Rate
Points
< 2 months
<= 60
1
61 to 69
2
>= 70
3
2 to 12 months
<= 50
1
51 to 59
2
>= 60
3
1 to 2 years
<= 40
1
41 to 44
2
>= 45
3
2 to 3 years
<= 34
1
35 to 39
2
>= 40
3
4 years
<= 30
1
31 to 35
2
>= 36
3
Age
Dyspnea
Points
0 to 2 years
normal feeding, activity, vocalizing
0
1 of: difficulty feeding, decreased vocalization, agitated
1
2 of: difficulty feeding, decreased vocalization, agitated
2
stops feeding, no vocalization, drowsy, confused
3
2 through 4 years
normal feeding, playing, vocalizing
0
1 of: decreased appetite, increased coughing after play, hyperactivity
1
2 of: decreased appetite, increased coughing after play, hyperactivity
2
stops eating or drinking, stops playing, drowsy or confused
3
Parameter
Finding
Points
retractions
none
0
intercostal
1
intercostal and substernal
2
intercostal, substernal and supraclavicular
3
auscultation
normal breathing, no wheezing
0
end-expiratory wheeze
1
wheeze during more of expiration
2
inspiratory and expiratory wheeze
3
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 1
• maximum score: 12
• The higher the score the more severe the asthma.
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