The severity of wheeze in a child with acute asthma is not always helpful as it does not necessarily correlate with how much at risk they are.
Having made your initial assessment, using your “ABCD” (or other preferred system), and having recorded your observations, there are 2 elements of the examination that will give you more clues than any other as to the condition of the child in front of you:
GENERAL APPEARANCE AND PARTICULARLY CONSCIOUS LEVEL OF THE CHILD
SIGNS OF INCREASED WORK OF BREATHING
If in doubt, an accurate assessment of these two features should help you make a safe clinical decision. The other alarm symptoms you should be aware of are listed Below: