Asthma Attack Wood Severity Score Calculator

Wheezing
Pulling
Vesicular murmur
Cyanosis
or PaO2 < 70 or SaO2 < 90%
Conscious


Score :

What Is the Asthma Attack Wood Severity Score?

The Asthma Attack Wood Severity Score is a standardized clinical assessment tool used to evaluate the severity of an acute asthma attack, particularly in pediatric patients. It is designed to help medical professionals and caregivers make informed decisions by providing an objective way to measure respiratory distress based on a combination of visible and audible symptoms. This tool is especially valuable in emergency or urgent care settings where time is critical, and quick decisions can significantly impact the outcome of treatment.

The score is based on five key clinical indicators: wheezing, chest retractions (pulling), vesicular breath sounds, cyanosis or oxygen saturation levels, and level of consciousness. Each of these parameters is rated on a scale from 0 to 2, with higher scores indicating more severe symptoms. The total score, ranging from 0 to 10, provides a clear picture of the patient's respiratory condition at the time of assessment.

This scoring system is particularly useful for monitoring changes in a patient's condition over time and can be used to track response to treatment. For example, a decreasing score may indicate that the patient is improving, while an increasing score may signal the need for more intensive intervention. It can also serve as a communication tool between healthcare providers, ensuring consistent evaluation and continuity of care.

Although the calculator provides valuable guidance, it is not a substitute for professional medical judgment. It is always important to consult a healthcare provider when dealing with asthma symptoms, especially during an acute episode. Used correctly, the Asthma Attack Wood Severity Score can enhance patient safety and support timely, appropriate medical care.

Who Should Use This Calculator?

The Asthma Attack Wood Severity Score Calculator is intended for use by healthcare professionals, including doctors, nurses, paramedics, and respiratory therapists, who are involved in the assessment and management of asthma in clinical or emergency settings. It is especially useful in pediatric care, where clear, objective evaluation of asthma severity is critical for timely and effective treatment.

While this tool is designed primarily for medical personnel, it may also be helpful for caregivers and parents of children with asthma who have been trained by a healthcare provider on how to monitor asthma symptoms. By using the calculator under proper guidance, non-professionals can better understand when to seek medical attention or when symptoms may require urgent intervention.

How the Score Is Calculated

The Asthma Attack Wood Severity Score is calculated by evaluating five key clinical signs commonly observed during an asthma attack. Each sign is assessed individually and assigned a score between 0 and 2, depending on the severity. The values for each category are then added together to obtain a total score ranging from 0 to 10. A higher total score indicates a more severe asthma attack.

Here is how each category contributes to the score:

  • Wheezing: This refers to the high-pitched sound made while breathing, usually on exhalation. The score ranges from 0 (none) to 2 (marked wheezing).
  • Pulling (Retractions): This describes the visible effort of breathing, such as chest wall retractions. The score ranges from 0 (no pulling) to 2 (severe pulling).
  • Vesicular Murmur: This assesses the normal breath sounds heard through a stethoscope. The score ranges from 0 (normal) to 2 (very diminished breath sounds).
  • Cyanosis or Oxygen Saturation: This evaluates oxygen levels in the body. It is scored from 0 (no cyanosis) to 2 (low oxygen levels even with supplemental oxygen).
  • Level of Consciousness: This indicates how alert the person is. The score ranges from 0 (normal consciousness) to 2 (coma).

Once all five categories are scored, the calculator adds the values to produce a final severity score. This total score helps guide clinical decisions, such as the need for medication, hospitalization, or emergency care.

Scoring Criteria Explained

Wheezing

Wheezing is a high-pitched whistling sound heard during breathing, often indicating airway narrowing. It is typically more noticeable during exhalation. This symptom reflects the degree of bronchial obstruction and is scored as follows:

  • 0 - None: No wheezing detected.
  • 1 - Moderate: Wheezing present, but not severe.
  • 2 - Marked: Loud or continuous wheezing, indicating significant airway constriction.

Pulling (Retractions)

Pulling refers to the visible effort used in breathing, seen as chest retractions—when the skin sucks in around the ribs or collarbone during inhalation. This sign reflects increased work of breathing.

  • 0 - None: Breathing appears normal, with no visible effort.
  • 1 - Moderate: Some chest retractions observed.
  • 2 - Severe: Pronounced retractions, possibly involving multiple areas of the chest and neck.

Vesicular Murmur

Vesicular murmur refers to the normal breath sounds heard when air moves in and out of the lungs. Reduced or absent sounds can indicate poor air entry.

  • 0 - Normal: Normal breath sounds heard on auscultation.
  • 1 - Diminished: Breath sounds are noticeably weaker.
  • 2 - Very Diminished: Barely audible or absent breath sounds, indicating a serious obstruction.

Cyanosis or Oxygen Levels

Cyanosis is a bluish discoloration of the skin due to low oxygen levels. This criterion also considers oxygen saturation measured through devices like a pulse oximeter.

  • 0 - Absent: Normal skin color and oxygen levels.
  • 1 - In ambient air: Signs of cyanosis or low oxygen (SaO2 < 90%) without supplemental oxygen.
  • 2 - Under FiO2 40%: Cyanosis present even when oxygen is being given, indicating severe hypoxemia.

Level of Consciousness

The level of consciousness reflects how alert or responsive a person is, which can deteriorate with severe respiratory distress or low oxygen supply to the brain.

  • 0 - Normal: Fully alert and responsive.
  • 1 - Sleepiness or Agitation: Noticeable changes in behavior, such as drowsiness, confusion, or restlessness.
  • 2 - Coma: Unconscious and unresponsive; a medical emergency.

How to Use the Calculator Step-by-Step

Using the Asthma Attack Wood Severity Score Calculator is simple and designed to provide quick results based on observed clinical signs. Follow the steps below to accurately assess the severity of an asthma attack:

  1. Observe the Patient: Begin by carefully observing the individual showing asthma symptoms. Pay attention to breathing sounds, effort, skin color, and responsiveness.
  2. Select a Score for Each Category: For each of the five clinical signs listed below, choose the option that best matches the patient’s condition:
    • Wheezing – None, Moderate, or Marked
    • Pulling (Retractions) – None, Moderate, or Severe
    • Vesicular Murmur – Normal, Diminished, or Very Diminished
    • Cyanosis or Oxygen Levels – Absent, In ambient air, or Under FiO2 40%
    • Level of Consciousness – Normal, Sleepiness or Agitation, or Coma
  3. Click the "Calculate" Button: Once all five selections have been made, click the “Calculate” button at the bottom of the form.
  4. View the Total Score: The calculator will instantly display the total score in the "Score" field. This number ranges from 0 (no distress) to 10 (very severe attack).
  5. Interpret the Results: Use the total score to help determine the severity of the asthma attack. A higher score means greater severity and may require urgent medical intervention.

Always use the results as a guide, not a diagnosis. If the person shows signs of severe distress or if you're uncertain, seek immediate medical attention.

Understanding Your Score

The total score from the Asthma Attack Wood Severity Score Calculator helps you determine how serious an asthma attack may be. This score ranges from 0 to 10, with higher numbers indicating more severe respiratory distress. Here’s how to interpret the score:

  • 0–3 (Mild Severity): The asthma symptoms are mild and may be manageable at home with prescribed medication such as an inhaler. However, continue to monitor the patient closely and follow your asthma action plan.
  • 4–6 (Moderate Severity): This score indicates moderate difficulty in breathing. Medical attention may be needed, especially if symptoms don’t improve with quick-relief medication. It’s best to contact a healthcare provider for guidance.
  • 7–10 (Severe Attack): This score reflects a serious asthma attack. The person may be struggling to breathe, showing signs of low oxygen, or altered consciousness. Emergency medical care is urgently required. Call emergency services or go to the nearest hospital immediately.

When to Seek Medical Help

While the Asthma Attack Wood Severity Score Calculator is a helpful tool for assessing the severity of an asthma attack, it is not a substitute for professional medical care. Knowing when to seek help can make a critical difference in managing asthma safely and effectively.

You should seek immediate medical attention if any of the following occurs:

  • The total score is between 7 and 10: This indicates a severe asthma attack that requires urgent treatment in a medical facility.
  • The patient is struggling to breathe or speak: If breathing becomes visibly labored or speaking in full sentences is difficult, call emergency services right away.
  • Lips or face appear bluish (cyanosis): This is a sign of low oxygen levels in the blood and may be life-threatening.
  • There is no improvement after using a rescue inhaler: If symptoms persist or worsen despite medication, do not wait—seek medical care.
  • The person becomes drowsy, confused, or unresponsive: Any changes in consciousness suggest a serious lack of oxygen and require emergency attention.

Frequently Asked Questions (FAQs)

1. What is the purpose of the Wood Severity Score?

The Wood Severity Score helps evaluate the seriousness of an asthma attack by assigning scores to physical symptoms. It offers a structured way to assess the patient's condition and guide further care decisions.

2. Can I use this calculator at home?

Yes, the calculator can be used by parents or caregivers who have been trained by a healthcare provider. However, it should not replace professional medical evaluation, especially during a severe asthma episode.

3. Is this calculator only for children?

The Wood Severity Score is primarily designed for pediatric patients, but some healthcare professionals may adapt it for older patients in clinical practice. Always follow your doctor’s advice regarding which tools are appropriate for your specific case.

4. What if the score seems wrong?

Always double-check each selection to ensure accuracy. If symptoms do not match the score or if you're unsure, seek medical advice rather than relying solely on the calculator.

5. Does a low score mean the patient is safe?

Not necessarily. A low score might still require attention, especially if symptoms worsen over time. Always monitor the person closely and follow your asthma action plan or seek medical care if needed.

6. Can this calculator diagnose asthma?

No, this tool cannot diagnose asthma. It is only intended to help assess the severity of an asthma attack in someone who already has a diagnosis. Always consult a healthcare provider for any medical concerns.

7. What should I do after calculating the score?

Review the total score and compare it with the severity ranges. Follow the recommended action (monitoring, contacting a doctor, or seeking emergency help). Always err on the side of caution when it comes to breathing difficulties.

References

  • Wood DW, Downes JJ, Lecks HI – A Clinical Scoring System for the Diagnosis of Status Asthmaticus in Children – 1972 – American Journal of Diseases of Children
  • Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM – Nelson Textbook of Pediatrics – 2020 – Elsevier
  • Behrman RE, Kliegman RM, Jenson HB – Nelson Essentials of Pediatrics – 2019 – Elsevier
  • Weinberger SE, Cockrill BA, Mandel J – Principles of Pulmonary Medicine – 2019 – Elsevier
  • Global Initiative for Asthma (GINA) – Global Strategy for Asthma Management and Prevention – 2023 – GINA

Disclaimer

The Asthma Attack Wood Severity Score Calculator is intended for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions you may have regarding a medical condition or the health and safety of a patient.

This tool is designed to support—but not replace—clinical judgment. Do not ignore or delay seeking professional medical help based on the results of this calculator. If you suspect a medical emergency, call emergency services immediately.

Use of this calculator is at your own risk. The developers and publishers of this tool disclaim any liability for decisions or actions taken based on its use.