Daniel Keszthelyi

models@cambiocds.com

To assess asthma severity among children using the Pediatric asthma score (PAS)

PAS can be used in children aged 2-18 years with asthma exacerbation to guide inpatient medical management. Can also be applied in the emergency department. PAS is helpful in patients unwilling or unable to comply with peak expiratory flow measurement. May quantify severity of asthma, but cannot predict response to treatment prior to intervention. Good inter-observer agreement among physicians, nurses, and respiratory therapists in an ED setting. Developed based on published guidelines of the National Asthma Education and Prevention Program in an effort to improve outcomes. PAS is calculated by adding up points given for 5 criteria (all ranging between 1 and 3): Respiratory Rate by Age, Oxygen Requirements, Auscultation, Retractions, Dyspnea PAS ranges between 5 and 15, and can be interpreted as: PAS Severity of Exacerbation Percent of Peak Flow (Personal Best or Predicted) 5-7 Mild >70% 8-11 Moderate 50-70% 12-15 Severe <50%

Should not be used to evaluate patients with significant comorbidities (e.g. sickle cell disease, cystic fibrosis), or in children below age 2.

[1] Kelly CS, Andersen CL, Pestian JP. Improved outcomes for hospitalized asthmatic children using a clinical pathway. Ann Allergy Asthma Immunol. 2000;84(5):509–516. [2] NAEPP: Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma- Summary Report. (2007). [erratum appears in J Allergy Clin Immunol. 2008 Jun;121(6):1330]. Journal of Allergy & Clinical Immunology, 120(5 Suppl): S94-138. [3] Nievas IFF, Anand KJS. Severe Acute Asthma Exacerbation in Children: A Stepwise Approach for Escalating Therapy in a Pediatric Intensive Care Unit.The Journal of Pediatric Pharmacology and Therapeutics : JPPT. 2013;18(2):88-104. doi:10.5863/1551-6776-18.2.88.

OBSERVATION.respiration.v2, OBSERVATION.basic_demographic.v1, OBSERVATION.pediatric_asthma_score.v0, EVALUATION.pas_assessment.v0