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Table 4 PRAM scoring table [21, 22]

From: Asthma

Criterion Description Score  
O2 saturation (%) ≥ 95 0  
92–94 1  
< 92 2  
Suprasternal retraction Absent 0  
Present 2  
Scalene muscle Absent 0  
contraction Present 2  
Air entrya Normal 0  
↓ at the base 1  
↓ at the apex and the base 2  
Minimal or absent 3  
Wheezingb Absent 0  
Expiratory only 1  
Inspiratory (± expiratory) 2  
Audible without stethoscope or silent chest (minimal or no air entry) 3  
PRAM score: (max. 12)   
Score 0–3 4–7 8–12
Severity Mild Moderate Severe
  1. On-line tool is available at https://www.mdcalc.com/pediatric-respiratory-assessment-measure-pram-asthma-exacerbation-severity
  2. PRAM Pediatric Respiratory Assessment Measure, RUL right upper lobe, RML right middle lobe, RLL right lower lobe, LUL left upper lobe, LLL left lower lobe, O2 oxygen
  3. aIn case of asymmetry, the most severely affected (apex-base) lung field (right or left, anterior or posterior) will determine the rating of the criterion
  4. bIn case of asymmetry, the two most severely affected auscultation zones, irrespectively of their location (RUL, RML, RLL, LUL, LLL), will determine the rating of the criterion