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. 2020 Jul 31;24:477. doi: 10.1186/s13054-020-03176-y

Fig. 1.

Fig. 1

Work of breathing scale assigning points to the respiratory frequency and activation of respiratory accessory muscles. Nasal flaring is determined visually by noticing widening of the nostrils during inspiration while standing at approximately one-meter from the patient. Activation of the sternocleidomastoid is determined by gentle palpation of its clavicular insertion using two fingers from the hand ipsilateral to the patient’s side noticing increased tension during inspiration. Activation of abdominal muscles is determined by gentle palpation of the abdomen using the hand ipsilateral to the patient’s side noticing increased tension during expiration