Table. Secondary severity assessment of acute asthma in children 0–5 years
Note: If features of more than one severity category are present, record the higher category as overall severity level
|
Mild/Moderate (all of): |
Severe (any of): |
Life-threatening (any of): |
---|---|---|---|
Speech |
Can talk or vocalise |
† |
Unable to vocalise due to dyspnoea |
Posture |
Can walk or crawl |
Lethargic |
Collapsed or exhausted |
Breathing |
Respiratory distress is not severe |
Paradoxical chest wall movement: inward movement on inspiration and outward movement on expiration (chest sucks in when person breathes in) or Use of accessory muscles of neck or intercostal muscles or ‘tracheal tug’ during inspiration or Subcostal recession (‘abdominal breathing’) |
Severe respiratory distress or Poor respiratory effort |
Consciousness |
Alert |
† |
Drowsy or unconscious |
Skin colour |
Normal |
† |
Cyanosis |
Respiratory rate |
Bradypnoea (indicates respiratory exhaustion) |
||
Heart rate |
or Bradycardia (may occur just before respiratory arrest) |
||
Chest auscultation |
Wheeze or Normal lung sounds |
† |
Silent chest or Reduced air entry |
Oxygen saturation (pulse oximetry) |
>94% |
90–94% |
<90% or Clinical cyanosis |
† Not applicable – may be the same as moderate and does not determine severity category
Normal respiratory and heart rates in children 0–5 years
|
Heart rate |
Respiratory rate |
---|---|---|
<1 year |
110–160 |
30–40 |
1–2 years |
100–150 |
25–35 |
2–5 years |
95–140 |
25–30 |
Source: Samuels M, Wieteska S. (Eds) Advanced paediatric life support: the practical approach. 5th edn. Wiley-Blackwell, Oxford; 2011.