MDCalc

Pediatric Respiratory Assessment Measure (PRAM) for Asthma Exacerbation Severity

Measures severity of airway obstruction in pediatric patients using clinical observations.

The PRAM has been used in patients 3-17 years old and works best to evaluate improvement of symptoms pre- and post-treatment.

O₂ saturation
Suprasternal retractions present
Scalene muscle contractions present
Air entry
If asymmetry, use the most severely affected lung field.
Wheezing
If asymmetry, use the two most severely affected auscultation zones.

Result:

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Advice

The PRAM works best when done initially and after treatment to show a trend, but this may be the same as clinician reassessment as well.