Pulmonary Score Helps Evaluate Pediatric Asthma Exacerbations

NEW YORK (Reuters Health) Mar 08 – A simple pulmonary score appears suitable for emergency department evaluation of asthmatic children too young or sick to undergo direct testing.
Dr. Sharon R. Smith, of Washington University School of Medicine and St. Louis Children's Hospital, and colleagues, note that assessment of lung function (FEV1) is often not possible in the emergency department and even peak expiratory flow (PEF) measurements may be unobtainable.

To provide an alternative, the researchers devised a scale, which scored respiratory rate, wheezing, and the level of accessory muscle use. To evaluate its validity, they compared pulmonary scores and PEF rates both before and after albuterol treatment of a convenience sample of children seeking emergency asthma treatment. The findings appeared in the February issue of Academic Emergency Medicine.

Both PEF and pulmonary scores improved after treatment. Mean PEF rose from 47.6% to 68.3% of predicted, nurse-obtained scores improved from a mean of 4 to 2.5, and physician-obtained scores from 4.1 to 2.1. Pre- and post-treatment PEF readings and pulmonary scores were significantly correlated.


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