Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm





    Chief Complaint


    Organ System


    Patent Pending

    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.
    When to Use
    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.


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    Next Steps
    Creator Insights


    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.

    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