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Allergy and Immunology · Emergency Medicine · Paediatrics

Pediatric Respiratory Assessment Measure (PRAM) calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

%

Allowed range: 50–100 %

Quick picks

Measure saturation in room air. At least 95% scores 0, 92% through 94% scores 1, and below 92% scores 2.

Suprasternal retraction
Scalene muscle contraction
Air entry

If the two lungs differ, rate the most severely affected apex-to-base field, right or left, anterior or posterior.

Wheezing

If the zones differ, the two most severely affected auscultation zones set the rating, wherever they sit.

Result

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Clinical inputs

  • Oxygen saturation in room air (%)Accepted range: 50 to 100
  • Suprasternal retraction
  • Scalene muscle contraction
  • Air entry
  • Wheezing

Primary source

Ducharme FM et al. The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers. J Pediatr. DOI: 10.1016/j.jpeds.2007.08.034. PMID: 18346499. Item weights were read from the CHU Sainte-Justine PRAM scoring table that cites this paper: oxygen saturation at least 95% = 0, 92–94% = 1, below 92% = 2; suprasternal retraction absent 0 or present 2; scalene contraction absent 0 or present 2; air entry normal 0, decreased at the base 1, decreased at the apex and base 2, minimal or absent 3; wheezing absent 0, expiratory only 1, inspiratory with or without expiratory 2, audible without a stethoscope or silent chest with minimal air entry 3. Maximum 12. The same five items and 0–12 range are printed in Arnold DH et al. J Asthma. 2013. Table 1. PMID: 23259729. The scoring table labels 0–3 mild, 4–7 moderate, and 8–12 severe. (2008)

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