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Table 5 Levels of severity of an asthma attack in children

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

Clinical signs Mild Moderate Severe Life-threatening
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Respiratory ratea Normal Increased Greatly increased Bradypnea/gasping
Heart rateb 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
  1. Not all clinical signs are necessary to classify a given level of severity
  2. 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
  3. bNormal values: at 2–12 months of age ≤160/min; at 1–2 years ≤120/min; at 3–8 years, ≤110/min