Over the winter every day children with asthma presented at our hospital with wheeze, and assessing the severity of dyspnoea is a very important part of our work. What treatment the wheezy child is given and decisions about admission or discharge depend on the assessments made.
Clinical skills in assessing dyspnoea are vitally important, however judgements can be aided by severity scores and asthma clinical pathways. Severity scores (over 35 are available for children), in conjunction with treatment pathways can be used to decide when to escalate treatment for example or which child does not require a nebuliser.
The need for training in the use of severity scores is highlighted in an article by Dr Colin V.E. Powell Arch Dis Child. 2015;100(9):813-815
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