Children's Healthcare of Atlanta
Emergency Department
Clinical Asthma Score
(CAS)
PATIENT IDENTIFICATION
Date: _________________
Score= 0
Absent or Mild
CLINICAL ASTHMA
SCORE
Respiratory Rate
24 to 36 months
3 to 6 years
> 6 years
<35
<30
<20
Score= 1
Moderate
Score= 2
Severe
35-55
30-50
20-40
>55
>50
>40
0.22-0.35
2
0.22-0.35
3
0.22-0.35
4
Moderate
Moderate
Moderate
Moderate
>0.35
>2
>0.35
>3
>0.35
>4
Severe
Severe
Severe
Severe
1st Assessment
/Triage Score
1st Aerosol
post score
2nd Aerosol
post score
3rd Aerosol
post score
O2 Requirement to keep sat  93%
18 to 35 months
3 to 6 years
> 6 years
FiO2
LPM- N/C
FiO2
LPM- N/C
FiO2
LPM- N/C
0.21
0
0.21
0
0.21
0
Dyspnea
WOB
Wheezing
Cough
Total (out of 12)
Mild
Mild
Mild
Mild
Dyspnea
Mild (Score =0)
Toddler normal speech
Child speaks in complete sentences
Wheezing
Mild (Score =0)
Breath sounds clear or coarse with good air
entry
Moderate (Score =1)
Toddler crying
Child speaks in phrases or partial sentences
Severe (Score =2)
Toddler no cyring
Child speaks in single words or short
phrases
CAS Initial Treatment Guide
>8=
Contact physician immediately
Continuous neb
Give steroids
Moderate (Score =1)
Inspiratory and/or expiratory wheeze
Absent wheeze but moderate dyspnea and/or
work of breathing
Mildly decreased air entry
6-8 =
Continuous treatment and steroids
Consider admission
4-5 =
Aerosol q 20 min x 3
Give steroids
Severe (Score =2)
Breath sounds nearly inaudible
Air entry markedly decreased
Absent wheeze but severe dyspnea and/or work
of breathing
2-3 =
Aerosol q 30 min x 2
Consider steroids
0-1 =
Aerosol x 1
THIS IS NOT A PHYSICIAN ORDER
Work of Breathing
Mild (Score =0)
No retractions or mild intercostal retractions
Cough
Mild (Score =0)
No or mild cough.
Moderate (Score =1)
Moderate intercostal retractions
Moderate accessory muscle use
Moderate (Score =1)
Frequent dry, tight, or hacky cough without loss
of breath
NOT A PERMANENT PART OF
THE MEDICAL RECORD.
SEND TO: Calvin Calmes
 Nasal flaring
Severe (Score =2)
Severe intercostal retractions
Severe accessory muscle use
Nasal flaring
Severe (Score =2)
Frequent dry, tight, or hacky cough with loss of
breath
03/29/05