In this section
Asthma
Bronchiolitis
Croup
Pneumonia
Minimal handling
Normal Ranges for Physiological Variables
Mild
Moderate
Severe
Behaviour
Normal
Able to talk normally
Some / intermittent irritability
Some limitation of ability to talk
Increasing irritability and / or lethargy
Marked limitation of ability to talk or unable to talk
Tachypnoea*(at rest - ie not crying)
Normal or mildly increase respiratory rate(normal values by age)
Increased respiratory rate
Increased or markedly reduced respiratory rate as the child tires.
Signs of increased work of breathing
Retraction(intercostal, suprasternal, costal margin)
Paradoxical abdominal breathing
Accessory muscle use
Nasal flaring Sternomastoid contraction (head bobbing) Forward posture
None or minimal
Moderate retractions and / or accessory muscle use
Marked increase in accessory muscle use with prominent chest retraction.
Oxygenation
Oxygenation is only of limited utility in judging severity in many paediatric respiratory conditions. Don't just focus on the SaO2 monitor. Look at the other signs.
O2 saturations less than 90% (in room air)
Any O2 requirement in croup is classed as severe
Cyanosis
Heart Rate
Normal or slight increase
Mildly increased
Significantly increased or bradycardia
Blood Pressure
Increased
Increased or decreased late.
Other Considerations:
Management of individual conditions can be found under the specific guideline.
Any child with severe respiratory distress should involve a senior clinician.
If management of severity is beyond the capability of the local health care facility.
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Last Updated January 2019