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Pediatric Respiratory Assessment Measure (PRAM) for Asthma Exacerbation Severity

O₂ saturation
≥ 95% 0
92-94% 1
< 92% 2
Suprasternal retractions present
No 0
Yes 2
Scalene muscle contractions present
No 0
Yes 2
Air entry
If asymmetry, use the most severely affected lung field.
Normal 0
Decreased at the base 1
Decreased at the apex and the base 2
Minimal or absent 3
If asymmetry, use the two most severely affected auscultation zones.
Absent 0
Expiratory only 1
Inspiratory (± expiratory) 2
Audible without stethoscope or silent chest (minimal or no air entry) 3


Result Interpretation

Ranges Ranges

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