Pediatric Respiratory Assessment Measure (PRAM)
Acute asthma severity in children.
Inputs
CompleteSuprasternal retraction
Scalene muscle contraction
Air entry
Wheezing
SpO₂ on room air
Worked calculation
Your values are highlighted.
- Points
When to use
- Children 2–17 years with acute asthma.
Pearls and pitfalls
- Moderate to severe: systemic corticosteroids plus repeated bronchodilators.
Why use
Validated across ages.
| Criterion | Points |
|---|---|
| Suprasternal retraction: Absent | 0 |
| Present | +2 |
| Scalene muscle contraction: Absent | 0 |
| Present | +2 |
| Air entry: Normal | 0 |
| Decreased at bases | +1 |
| Widespread decrease | +2 |
| Absent or minimal | +3 |
| Wheezing: Absent | 0 |
| Expiratory only | +1 |
| Inspiratory and expiratory | +2 |
| Audible without stethoscope, or silent chest | +3 |
| SpO₂ on room air: 95% or higher | 0 |
| 92–94% | +1 |
| Below 92% | +2 |