Pediatric Respiratory Scoring Tool

Respiratory Rate (RR)

Age 2 Months or Younger

• 40 breaths per minute or less: 0 points.
• 41 to 60 breaths per minute: 1 point.
• 61 to 69 breaths per minute: 2 points.
• 70 breaths per minute or above: 3 points.

Age 2 to 12 Months

• 30 breaths per minute or less: 0 points.
• 31 to 50 breaths per minute: 1 point.
• 51 to 59 breaths per minute: 2 points.
• 60 breaths per minute or above: 3 points.

Age 1 to 2 Years

• 30 breaths per minute or less: 0 points.
• 31 to 40 breaths per minute: 1 point.
• 41 to 44 breaths per minute: 2 points.
• 45 breaths per minute or above: 3 points.

Retractions

• None: 0 points.
• Subcostal or intercostal retractions: 1 point.
• Two of the following - subcostal, intercostal, or substernal retractions - OR nasal flaring in an infant younger than 1 year: 2 points.
• Three of the following - subcostal, intercostal, substernal, suprasternal, or supraclavicular retractions - OR nasal flaring or head bobbing in an infant younger than 1 year: 3 points.

Dyspnea

• Normal feeding and normal activity: 0 points.
• One of the following - difficulty feeding, less cry, or agitated and inconsolable: 1 point.
• Two of the following - difficulty feeding, less cry, or agitated and inconsolable: 2 points.
• Stops feeding, no activity, no vocalization, OR drowsy and confused: 3 points.

Wheezing

• No wheezing and normal breathing: 0 points.
• End-expiration only: 1 point.
• Entire expiratory phase: 2 points.
• Inspiration and expiration, diminished breath sounds, or both: 3 points.

Severity by Total Score

• Mild: total score 1 to 4.
• Moderate: total score 5 to 8.
• Severe: total score 9 or higher.