Performance of a Novel Clinical Score, the Pediatric Asthma Severity Score (PASS), in the Evaluation of Acute Asthma

Gorelick, Marc H.; Stevens, Molly W.; Schultz, Theresa Ryan; Scribano, Philip V.

doi:10.1111/j.1553-2712.2004.tb01365.x

Cited by 68 publications

(41 citation statements)

References 12 publications

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“…Individuals and institutions should assess the patient and document pretherapy and posttherapy changes using an objective means of evaluation. Some of the documentation tools that have been used can be found in articles by Alario et al, 45 Bierman and Pierson, 63 Gadomski et al, 54 Lowell et al, 33 Wainwright et al, 51 Schuh et al, 64 and Gorelick et al 65 In addition, a documentation tool has been developed by Cincinnati Children's Hospital (Cincinnati, OH). 66 Extrapolation from the studies discussed above suggests that epinephrine may be the preferred bronchodilator for this trial in the emergency department and in hospitalized patients.…”

Section: Epinephrine/adrenalinementioning

confidence: 99%

Diagnosis and Management of Bronchiolitis

2006

Pediatrics

880

293

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Bronchiolitis is a disorder most commonly caused in infants by viral lower respiratory tract infection. It is the most common lower respiratory infection in this age group. It is characterized by acute inflammation, edema, and necrosis of epithelial cells lining small airways, increased mucus production, and bronchospasm.The American Academy of Pediatrics convened a committee composed of primary care physicians and specialists in the fields of pulmonology, infectious disease, emergency medicine, epidemiology, and medical informatics. The committee partnered with the Agency for Healthcare Research and Quality and the RTI International-University of North Carolina Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to the diagnosis, management, and prevention of bronchiolitis. The resulting evidence report and other sources of data were used to formulate clinical practice guideline recommendations.This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen. Recommendations are made for prevention of respiratory syncytial virus infection with palivizumab and the control of nosocomial spread of infection. Decisions were made on the basis of a systematic grading of the quality of evidence and strength of recommendation. The clinical practice guideline underwent comprehensive peer review before it was approved by the American Academy of Pediatrics.This clinical practice guideline is not intended as a sole source of guidance in the management of children with bronchiolitis. Rather, it is intended to assist clinicians in decision-making. It is not intended to replace clinical judgment or establish a protocol for the care of all children with this condition. These recommendations may not provide the only appropriate approach to the management of children with bronchiolitis. INTRODUCTIONTHIS GUIDELINE EXAMINES the published evidence on diagnosis and acute management of the child with bronchiolitis in both outpatient and hospital settings, including the roles of supportive therapy, oxygen, bronchodilators, antiinflammatory agents, antibacterial agents, and antiviral agents and make recommendations to influence clinician behavior on the basis of the evidence. Methods of prevention All clinical practice guidelines from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of care. Variations, taking into account individual circumstances, may be appropriate. Key Word bronchiolitisAbbreviations CAM-complementary and alternative medicine LRTI-lower respiratory tract infection AHRQ-Agency for Healthcare Research and Quality RSV-respiratory syncytial virus AAP-American Academy of Pediatrics AAFP-American Academy...

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Section: Epinephrine/adrenalinementioning

confidence: 99%

Diagnosis and Management of Bronchiolitis

2006

Pediatrics

880

293

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“…The components of the checklist were derived from previously published and validated respiratory scores, including the Pediatric Asthma Severity Score and the Pediatric Respiratory Assessment Measure. [17][18][19] Each component of the Respiratory Observation Checklist was assessed in a dichotomous fashion (present or absent). Specific physical signs included: age-appropriate tachypnea; perioral cyanosis; nasal flaring; tripoding; thoracoabdominal asynchrony; and supraclavicular, substernal, and intercostal retractions.…”

Section: Methodsmentioning

confidence: 99%

Reliability of Telemedicine in the Assessment of Seriously Ill Children

Siew¹,

Hsiao²,

McCarthy³

et al. 2016

Pediatrics

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BACKGROUND AND OBJECTIVE: Data are limited that establish the clinical reliability of telemedicine in evaluating children who are seriously ill. Evaluation of a seriously ill child poses a challenge in that telemedicine is primarily visual, without the ability to perform a "hands-on" physical examination. Previous studies evaluating observation in assessing febrile children and children in respiratory distress have validated observation as both predictive and reliable in detecting underlying illness. The purpose of this study was to determine the interobserver reliability of telemedicine observations, compared with bedside observations, in assessing febrile children and children in respiratory distress.

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“…3 For example, some severity measures require blood gas analyses; others require numerous objective measures, or demanding assessments such as inspiratory/expiratory ratios. [4][5][6][7] The pulmonary score (PS) was developed to provide a ''userfriendly'' measure of asthma severity for children with an acute asthma exacerbation.…”

Section: Introductionmentioning

confidence: 99%

Validation of Pulmonary Score in the Evaluation of Acute Exacerbation of Asthma

Chandrakala¹,

Ramesh²,

Rao³

2014

jemds

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BACKGROUND & OBJECTIVES:Numerous asthma scoring systems have been devised which combine a number of physical signs to estimate the severity of an acute asthma exacerbation. Although more than 16 scoring systems exist, many are difficult to use. The pulmonary score was developed to provide ''user-friendly'' measure of asthma severity for children with acute asthma exacerbation. The objective of the study is to study the efficacy of pulmonary score in assessing the severity of acute exacerbation of asthma in comparison to peak expiratory flow rate. METHODS: The study sampled 50 children, aged 5-18 years, with mild to moderate acute exacerbation of asthma. The PEFR (best of three attempts) and the PS were measured before and after treatment at 5, 10 and 15 minutes. The PS includes respiratory rate, wheezing, and retractions, each rated on a 0-3 scale. Pre-and post-treatment PEFR and PS score were compared using paired t-tests to establish construct validity. Correlation of pre-and post-treatment PSs with PEFRs was measured to establish criterion validity. RESULTS: The mean predicted PEFR improved with treatment by 21.2% (from 50.8% to 72.0% of predicted) (p <0.0001) at 15 minutes. The mean PS improved by 2.8 (from 4.8 to 2) (p < 0.0001) at 15 minutes. Pre-and post-treatment PSs were significantly correlated with PEFRs. The correlation of pre-treatment PEFR and PS is r = -0.497 (p = 0.000), that for post treatment at 15 minutes is r = -0.589 (p = 0.000). INTERPRETATION & CONCLUSION: These data support the construct and criterion validities of the PS as a measure of asthma severity among children. The PS is a practical substitute to estimate airway obstruction in children who are too young or too sick to obtain PEFRs.

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Performance of a Novel Clinical Score, the Pediatric Asthma Severity Score (PASS), in the Evaluation of Acute Asthma

Cited by 68 publications

References 12 publications

Diagnosis and Management of Bronchiolitis

Diagnosis and Management of Bronchiolitis

Reliability of Telemedicine in the Assessment of Seriously Ill Children

Validation of Pulmonary Score in the Evaluation of Acute Exacerbation of Asthma

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