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Mild Attack

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Mild Attack

*Mild difficulty in breathing.

*Breathing slightly faster than normal.

*Speaking in complete sentences is easily accomplished.

*Mild complaints of coughing, wheezing, tight chest, shortness of breath.

*Skin color is good.

*Child is alert and oriented.

*No compression in the muscles between the ribs.

*Peak flow rate is 70–90 percent of the child’s personal best.

Moderate Attack

*Moderate difficulty in breathing.

*Breathing faster than usual.

*Speaking is affected (no complete sentences because of breathing difficulty).

*Moderate complaints of coughing, wheezing, shortness of breath.

*Skin color is normal to pale.

*Child is alert and oriented.

*Slight to moderate compression of the muscles between the ribs is necessary to breathe (often called “drawing in”).

*Peak flow rate is 50–70 percent of the child's personal best.

Severe Attack

*Breathing is extremely difficult.

*Breathing is very fast or very slow (labored).

*Single words are spoken with difficulty (difficulty in breathing).

*Severe complaints of coughing, wheezing, shortness of breath, tightness in the chest.

*Skin color is poor.

*Child may be drowsy –– alertness has diminished.

*Drawing in of neck abdomen and chest muscles to breathe.

*Peak flow rate is less than 50 percent of the child’s personal best.

Signs The Child Is Getting Worse

*Asthma symptoms occur more frequently.

*Asthma symptoms get worse in severity.

*Asthma medications do not seem to help lessen the coughing or breathing difficulty.

*Frequent trips to an emergency department (hospital or doctor).

*Admission to the hospital for asthma treatment.

*Large changes in peak flow rate (more than 20 percent) between morning and evening.

*Number of symptoms increases.

*Attacks longer in duration.

*Anti-inflammatory drugs are needed with increased frequency.

*Attacks escalate more rapidly.

*Panic attacks coupled with severe confusion with each asthma attack.

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