Vichyanond et al reported the Siriraj Clinical Asthma Score (SCAS) for evaluating pediatric patients with asthma. This can help to identify a patient who requires aggressive management. The authors are from Siriraj Hospital and Mahidol University in Bangkok.
Patient selection: pediatric, 1-12 years of age
Items not included due to poor validity and/or inter-rater reliability:
(1) cyanosis
(2) depressed cerebral function
(3) inspiration:expiration ratio
(4) breath sound quality
(5) air entry
Parameters:
(1) respiratory rate in breaths per minute
(2) wheezing
(3) dyspnea
(4) oxygen saturation in percent
(5) use of accessory muscles
Parameter
Finding
Points
respiratory rate
< 40
0
40-60
1
> 60
2
wheezing
none
0
expiration
1
expiration and inspiration
2
dyspnea
none
0
mild
1
marked
2
oxygen saturation
>= 95%
0
92-94%
1
<= 91%
2
use of accessory muscles
none
0
mild to moderate retractions
1
marked retractions
2
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >= 9 had a sensitivity of 98% and specificity of 100% for severe asthma.
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