Pediatric Respiratory Assessment Measure (PRAM) for Asthma Exacerbation Severity

Why Use

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

When to Use

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

Formula

Pearls / Pitfalls

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).

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.

More Information

Score interpretation: Score Asthma Severity 0-3 Mild 4-7 Moderate 8-12 Severe