Management of acute respiratory diseases in the pediatric population: the role of oral corticosteroids

Table 5 Levels of severity of an asthma attack in children

Clinical signs	Mild	Moderate	Severe	Life-threatening
Able to talk	Able to talk in sentences	Cannot complete sentences	Able to pronounce a few words	-
Respiratory rate^a	Normal	Increased	Greatly increased	Bradypnea/gasping
Heart rate^b	Normal	Increased	Greatly increased	Fall in heart rate
Complexion	Normal	Pallor	Pallor/cyanosis	Cyanosis
Level of consciousness	Normal	Restlessness	Severe restlessness	Obtundation, drowsiness
Wheezing	Mild expiratory	Expiratory	Expiratory/Inspiratory	Silent chest
Use of accessory muscles of respiration	Absent	Mild	Moderate	Paradoxical respiratory movement
SpO2	>95%	92–95%	<92%	<90%
PaCO2 (mmHg)	<38	38–42	>42	>42
Peak expiratory flow	>80%	60–80%	<60%	Not measurable

Not all clinical signs are necessary to classify a given level of severity
^aNormal values: at <2 months of age ≤60/min; at 2–12 months ≤50/min; at 1–5 years ≤40/min; at 6–9 years ≤30/min
^bNormal values: at 2–12 months of age ≤160/min; at 1–2 years ≤120/min; at 3–8 years, ≤110/min

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