Peak expiratory flow

80% to 100% of personal best

50% to 79% of personal best

Less than 50% of personal best

Breathing

Normal or slightly faster

Faster than normal

Rapid, and the child may appear preoccupied with breathing; may want to sit upright to help breathing

Breath

Mild or no shortness of breath; can speak in full sentences

Short of breath; can speak in short phrases or parts of sentences

Very short of breath; speaks in single words or short phrases

Chest

Does not or slightly uses chest muscles to breathe

Uses chest and neck muscles to breathe. The skin between, under, and above the ribs collapses inward with each breath.

Uses chest and neck muscles to breathe and may open nostrils wide; may clutch at the chest

Skin

Normal skin color

Pale skin color

Very pale or bluish skin color; may sweat more than normal

Wheezing

Wheezes while breathing out

Wheezes while breathing in and out

Does not wheeze while breathing. This indicates little or no air in the airways.

Alertness

Normally alert

Normally alert

Not as alert as usual and may appear anxious