Pulmonary Index Score (PIS)

Score	Respiratory rate		Wheezing	Inspiratory/ expiratory ratio	Accessory muscle use	Oxygen saturation
Score	<6 years old	≥6 years old	Wheezing	Inspiratory/ expiratory ratio	Accessory muscle use	Oxygen saturation
0	≤30	≤20	None*	2:1	None	99 to 100
1	31 to 45	21 to 35	End expiration	1:1	+	96 to 98
2	46 to 60	36 to 50	Entire expiration	1:2	++	93 to 95
3*	>60	>50	Inspiration and expiration	1:3	+++	<93

The total score ranges from 0 to 15. The PIS is interpreted as follows:

Mild exacerbation: <7
Moderate exacerbation: 7 to 11
Severe exacerbation: ≥12

However, the PIS may underestimate the degree of illness in an older child. Older children, with prolonged expiratory phases, may become bradypneic with a moderate-to-severe attack. As such, their score for respiratory rate may be falsely reassuring.

* A score of 3 is given for "wheezing" if there is no wheezing due to minimal air entry.

Courtesy of Richard Scarfone, MD, FAAP.

Graphic 53797 Version 13.0

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Pulmonary Index Score (PIS)