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O₂ saturation
≥ 95% 92-94% < 92%
Suprasternal retractions present
No Yes
Scalene muscle contractions present
No Yes
Air entry If asymmetry, use the most severely affected lung field.
Normal Decreased at the base Decreased at the apex and the base Minimal or absent
Wheezing If asymmetry, use the two most severely affected auscultation zones.
Absent Expiratory only Inspiratory (± expiratory) Audible without stethoscope or silent chest (minimal or no air entry)

Pediatric Respiratory Assessment Measure (PRAM) for Asthma Exacerbation Severity

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