Mild | Moderate | Severe | Subset: Respiratory arrest imminent | |
Symptoms | ||||
Breathlessness | While walking | While at rest (infant - softer, shorter cry, difficulty feeding) | While at rest (infant - stops feeding) | |
Can lie down | Prefers sitting | Sits upright | ||
Talks in | Sentences | Phrases | Words | |
Alertness | May be agitated | Usually agitated* | Usually agitated* | Drowsy or confused |
Signs | ||||
Respiratory rate | Increased | Increased | Often >30/minute | Poor respiratory effort, appears exhausted |
Guide to rates of breathing in awake children: | ||||
Age | Normal rate | |||
<2 months | <60/minute | |||
2 to 12 months | <50/minute | |||
1 to 5 years | <40/minute | |||
6 to 8 years | <30/minute | |||
Use of accessory muscles; suprasternal retractions | Usually not | Commonly | Usually | Paradoxical thoracoabdominal movement |
Wheeze | Moderate, often only end expiratory | Loud; throughout exhalation | Usually loud; throughout inhalation and exhalation | Absence of wheeze (silent chest) |
Pulse/minute | <100 | 100 to 120 | >120 | Bradycardia |
Guide to normal pulse rates in children: | ||||
Age | Normal rate | |||
2 to 12 months | <160/minute | |||
1 to 2 years | <120/minute | |||
2 to 8 years | <110/minute | |||
Pulsus paradoxus | Absent to <10 mmHg | May be present 10 to 25 mmHg | Often present >25 mmHg (adult) 20 to 40 mmHg (child) | Absence suggests respiratory muscle fatigue |
Other | Cyanosis | |||
Functional assessment | ||||
PEF percent predicted or percent personal best | ≥70% | Approximately 40 to 69% or response to inhaled beta-agonists lasts <2 hours | <40% | <25% Note: PEF testing may not be needed in very severe attacks |
PaO2 (in room air) | Normal (test not usually necessary) | ≥60 mmHg (test not usually necessary) | <60 mmHg: possible cyanosis | |
PCO2 | <42 mmHg (test not usually necessary) | <42 mmHg (test not usually necessary) | ≥42 mmHg: possible respiratory failure | |
SpO2 percent (in room air) at sea level | >95% (test not usually necessary) | 90 to 95% (test not usually necessary) | <90% | |
Hypercapnia (hypoventilation) develops more readily in young children than in adults and adolescents. | ||||
BP | Hypotension |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟