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    Patent Pending

    Pediatric Respiratory Assessment Measure (PRAM) for Asthma Exacerbation Severity

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

    INSTRUCTIONS

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

    Pediatric patients (3-17 years old) with asthma exacerbations.

    • The Pediatric Respiratory Assessment Measure (PRAM) provides an objective assessment of asthma exacerbation severity and can predict likelihood of admission or extended ED stay.
    • The PRAM does use clinical findings like retractions (which can play a direct role in the decision to admit), and it may over-estimate the score's independent value.
    • The PRAM is not typically used in severe asthma exacerbations, as these obviously require very aggressive, intensive treatment (including admission).

    This score can help decide which patients need admission, especially when providers disagree or the patient may be “borderline” for needing admission.

    ≥ 95%
    0
    92-94%
    +1
    < 92%
    +2
    No
    0
    Yes
    +2
    No
    0
    Yes
    +2
    Normal
    0
    Decreased at the base
    +1
    Decreased at the apex and the base
    +2
    Minimal or absent
    +3
    Absent
    0
    Expiratory only
    +1
    Inspiratory (± expiratory)
    +2
    Audible without stethoscope or silent chest (minimal or no air entry)
    +3

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Francine Ducharme

    About the Creator

    Francine Ducharme, MD, is a professor of pediatrics and an affiliate professor in the Department of Social and Preventive Medicine at the University of Montreal. She currently practices as a pediatrician and epidemiologist at CHU Sainte-Justine. Her research focus is on educational and drug interventions and improved pediatric respiratory guideline compliance.

    To view Dr. Francine Ducharme's publications, visit PubMed

    Are you Dr. Francine Ducharme? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Francine Ducharme
    Are you Dr. Francine Ducharme?