Table 1.
Classification of asthma severity according to the guidelines of the Italian Society of Pediatrics [8]. Normal values for respiratory rate: <2 months: <60 apm; 2–12 months: <50 apm; 1–5 yrs: <40 apm; 6–9 years: <30 apm; 10–14 yrs: <20 apm. Normal values for heart rate: 0–12 months: <160 bpm; 1-2 yrs: <120 bpm; 2–8 yrs: <110 bpm. Not all signs are needed for defining the severity of an exacerbation. apm: acts per minute; bpm: beats per minute; PEF: peak expiratory flow; FEV1: forced expiratory volume in the 1st second; SaO2: arterial oxygen saturation; PaCO2: partial pressure of carbon dioxide in arterial blood.
| Mild | Moderate | Severe | Life-threatening | |
|---|---|---|---|---|
| Talk | Able to converse | Phrases | Words | None |
| Respiratory rate | Normal | Increased | Increased | Bradypnea/gasping |
| Colour | Normal | Pale | Pale/cyanosis | Cyanosis |
| Level of consciousness | Normal | Agitation | Agitation | Confusion/drowsiness |
| Wheezing | End of expiration | Expiration | Expiration/inspiration | Absent |
| Use of accessory muscles of respiration | Absent | Moderate | Remarkable | Paradoxical breathing |
| Heart rate | Normal | Increased | Increased | Increased/bradycardia |
| PEF-FEV1 (% of predicted or personal best) | >80% | 60–80% | <60% | Nonexecutable |
| SpO2 (room air) | >95% | 92–95% | <92% | <90% |
| PaCO2 (mmHg) | <38 | 38–42 | >42 | >42 |