pram_score: Pediatric Respiratory Assessment Measure (PRAM)

In cliot: Clinical Indices and Outcomes Tools

Pediatric Respiratory Assessment Measure (PRAM)

Description

Calculates the PRAM score to assess the severity of airway obstruction in pediatric patients (ages 1-17) with acute asthma exacerbations. The score evaluates five clinical signs: suprasternal retractions, scalene muscle contraction, air entry, wheezing, and oxygen saturation.

Usage

pram_score(suprasternal_retractions, scalene_muscle_contraction, air_entry,
           wheezing, oxygen_saturation)

Arguments

suprasternal_retractions	Numeric (0 or 1). Presence of suprasternal retractions. (1 = Present [+2 pts], 0 = Absent).
scalene_muscle_contraction	Numeric (0 or 1). Presence of scalene muscle contraction. (1 = Present [+2 pts], 0 = Absent).
air_entry	Numeric (0-2). Assessment of air entry. 0: Normal. 1: Decreased at the base. 2: Widespread decrease.
wheezing	Numeric (0-3). Assessment of wheezing. 0: Absent. 1: Expiratory only. 2: Inspiratory and Expiratory. 3: Audible without stethoscope or silent chest.
oxygen_saturation	Numeric. Oxygen saturation (%) on room air. >= 95%: 0 pts. 92-94%: 1 pt. < 92%: 2 pts.

Value

A list containing:

PRAM_Score	The calculated total score (Range 0-12).
Severity_Classification	Interpretation of severity (Mild 0-3, Moderate 4-7, Severe 8-12).

References

Chalut DS, Ducharme FM, Davis GM. The Preschool Respiratory Assessment Measure (PRAM): a responsive index of acute asthma severity. J Pediatr. 2000;137(6):762-768. doi:10.1067/mpd.2000.109119

Examples

# Example 1: Moderate Severity
# Retractions (2), Scalene (0), Air Entry Decreased Base (1), Exp Wheeze (1), SpO2 93% (1)
# Score = 5
pram_score(1, 0, 1, 1, 93)

# Example 2: Severe Severity
# Retractions (2), Scalene (2), Widespread decrease (2), Insp/Exp Wheeze (2), SpO2 90% (2)
# Score = 10
pram_score(1, 1, 2, 2, 90)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.