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Classification of asthma severity

Clinical featuresMildModerateSevereImpending respiratory failure
Mental statusNormalMight look agitatedUsually agitatedDrowsy or confused
ActivityNormal activity and exertional dyspneaDecreased activity or feeding (infant)Decreased activity, infant stops feedingUnable to eat
SpeechNormalSpeaks in phrasesSpeaks in wordsUnable to speak
Work of breathingMinimal intercostal retractionsIntercostal and substernal retractionsSignificant respiratory distress. Usually all accessory muscles involved, and may display nasal flaring and paradoxical thoraco-abdominal movementMarked respiratory distress at rest. All accessory muscles involved, including nasal flaring and paradoxical thoraco-abdominal movement
Chest auscultationModerate wheezeLoud pan-expiratory and inspiratory wheezeWheezes might be audible without stethoscopeThe chest is silent (absence of wheeze)
SpO2 on room air>94%91–94%<90%<90%
Peak flow versus personal best>80%60–80%best <60%Unable to perform the task