TABLE 4.

Pediatric Respiratory Assessment Measure (PRAM) scoring table

Oxygen saturation	≥95%		0
	92%–94%		1
	<92%		2
Suprasternal retraction	Absent		0
	Present		2
Scalene muscle contraction	Absent		0
	Present		2
Air entry*	Normal		0
	↓ At the base		1
	↓ At the apex and the base base		2
	Minimal or absent		3
Wheezing†	Absent		0
	Expiratory only		1
	Inspiratory (± expiratory)		2
	Audible without stethoscope or silent chest (minimal or no air entry)		3
PRAM score (maximum 12)
Score	0–3	4–7	8–12
Severity	Mild	Moderate	Severe

Adapted from Ducharme FM, Chalut D, Plotnick L, et al. The Pediatric Respiratory Assessment Measure: A valid clinical score for assessing acute asthma severity from toddlers to teenagers. J Pediatr 2008;152(4):476–80, 480.e1. This tool is available at <www.chu-sainte-justine.org/childasthmatools>.

^*In case of asymmetry, the most severely affected (apex-base) lung field (right or left, anterior or posterior) will determine the rating of the criterion;

^†In case of asymmetry, the two most severely affected auscultation zones, irrespectively of their location (right upper lobe, right middle lobe, right lower lobe, left upper lobe, left lower lobe), will determine the rating of the criterion. ↓ Decreased