Respiratory Rate (breaths per minute)

RR ≤ 20 breaths/min (0 pts)+0RR 21–25 breaths/min (1 pt)+1RR 26–30 breaths/min (2 pts)+2RR > 30 breaths/min (3 pts)+3

SpO₂ on Room Air

SpO₂ ≥ 97% on room air (0 pts)+0SpO₂ 94–96% on room air (1 pt)+1SpO₂ 90–93% on room air (2 pts)+2SpO₂ < 90% on room air or requires supplemental O₂ to achieve ≥ 90% (3 pts)+3

Accessory Muscle Use (SCM, scalene, intercostal retractions)

No accessory muscle use (0 pts)+0Mild — slight visible use of accessory muscles (1 pt)+1Moderate — clear accessory muscle use, major effort (2 pts)+2Severe — tripod position, marked accessory use, paradoxical breathing (3 pts)+3

Air Entry on Auscultation (both lung fields)

Normal bilateral air entry (0 pts)+0Mildly reduced air entry (1 pt)+1Moderately reduced air entry (2 pts)+2Minimal air entry — near-silent chest (3 pts)+3

Wheeze on Auscultation

No wheeze (normal or completely silent chest — assess context) (0 pts)+0Limited end-expiratory wheeze (1 pt)+1Expiratory wheeze throughout full exhalation (2 pts)+2Inspiratory and expiratory wheeze OR silent chest with severe distress (3 pts)+3

Respiratory Distress Assessment Instrument (RDAI) / Pulmonary Index Score — Asthma Severity

Respiratory Distress Assessment Instrument (RDAI) / Pulmonary Index Score — Asthma Severity