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Severity of Asthma Exacerbation

 

 

Mild

Moderate

Severe

Respiratory Rate 

2-3 yrs: <34/min 

4-5 yrs: <30/min

6-12 yrs: <26/min

>12 yrs: <23/min

2-3 yrs: 35-39/min

4-5 yrs: 31-35/min

6-12 yrs: 27-30/min

>12 yrs: 24-27/min

2-3 yrs: >40/min

4-5 yrs: >36/min

6-12 yrs: >31/min

>12 yrs: >28/min

Pulse Oximetry (SpO2) Requirement

>95% on room air

90-95% on room air

<90% on room air

Ausculation

Normal or end expiratory wheeze

Expiratory wheezing

Inspiratory and expiratory wheeze or diminished breath sounds

Retractions

None or intercostal

Intercostal and substernal

Intercostal, substernal, and supraclavicular

Dyspnea

Speaks in sentences

Speaks in partial sentences

Speaks in single words or short phrases

Patients may not display all signs/symptoms in a single column. Clinical judgment is essential to the assessment of severity.

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.