PRAM — paediatric asthma

PRAM — paediatric asthma

Principle

Description of acute asthma exacerbation severity in children.

Scope

Child aged 2 to 17 years with an acute asthma exacerbation. Not a universal scale for dyspnoea, bronchiolitis or neonatal distress. A silent chest indicates severity despite the absence of audible wheeze.

Interpretation limits

CPS classes: 0–3 mild, 4–7 moderate, 8–12 severe. Also assess consciousness, fatigue, history and treatment response; no automatically proposed treatment or dose.

Formula and logic

PRAM = SpO₂(0–2) + retractions(0/2) + scalenes(0/2) + air entry(0–3) + wheeze(0–3). Total 0–12.

Interpretation

0–3

Mild exacerbation

4–7

Moderate exacerbation

8–12

Severe exacerbation

Definition version : 0.3.0

Sources

• Société canadienne de pédiatrie — Exacerbation aiguë d’asthme chez l’enfant — tableau PRAM

  2021 · Table 1: five criteria, exact points, asymmetry and silent chest; categories 0–3 / 4–7 / 8–12. Full institutional source read.

• Ducharme et al. · Journal of Pediatrics — PRAM — validation chez les enfants de 2 à 17 ans

  2008 · Record/abstract of the prospective study: scope 2–17 years. No new clinical validation claimed.

• Child Health BC — PRAM — aide institutionnelle, oxygène lors de la mesure

  Accessed on 2026-10-06 · Confirms measurement without supplemental oxygen; thresholds from CPS 2021, without reproducing the ambiguous symbol in the BC PDF and without automatically instructing oxygen withdrawal.