Usually quiet, no wheeze Expiratory wheeze, later may also be inspiratory wheeze and may have no breath sounds Mild expiratory wheeze Expiratory wheeze, may also be inspiratory wheeze
12-16/min >20/min or <8/min 16-20/min >20/min
Speaks in sentences Speaks in clear and steady sentences Speaks in short phrases only Speaks in words only or unable to speak
>20/min or <8/min >20/min 12-16/min 16-20/min
May be unable to cough Usually quiet, no wheeze May have a cough
60-100/min 100-120/min >120 or <60 as a late sign
>120 or <60 as a late sign 60-100/min 100-120/min
Little effort with small chest movement Marked chest movement with accessory muscles, intercostal retraction and/or tracheal tugging May be slight increase in normal chest movement Marked chest movement and may be some use of accessory muscles
May be altered Altered or unconscious Alert
Pale and sweaty, may be cyanosed Normal May be pale and sweaty
May be slightly prolonged expiratory phase Regular even cycles Prolonged expiratory phase
Crackles at bases, to mid-zone Coarse crackles full field, with possibly a wheeze expiratory +/- inspiratory No crackles or scattered fine basal crackles, e.g. postural May have some fine crackles at bases
60-100/min >120 or <60 as a late sign 100-120/min
Regular even cycles Prolonged expiratory phase May be slightly prolonged expiratory phase
Little effort with small chest movement Marked chest movement and may be some use of accessory muscles Marked chest movement with accessory muscles, intercostal retraction and/or tracheal tugging May be slight increase in normal chest movement
May have a cough May be unable to cough Usually quiet, no wheeze
Likely calm, may be mildly anxious Distressed, anxious, fighting for breath, exhausted, catatonic May be distressed, anxious Calm, quiet
Expiratory wheeze, may also be inspiratory wheeze Expiratory wheeze, later may also be inspiratory wheeze and may have no breath sounds Mild expiratory wheeze Usually quiet, no wheeze
No crackles or scattered fine basal crackles, e.g. postural Coarse crackles full field, with possibly a wheeze expiratory +/- inspiratory May have some fine crackles at bases Crackles at bases, to mid-zone
No crackles or scattered fine basal crackles, e.g. postural Crackles at bases, to mid-zone May have some fine crackles at bases Coarse crackles full field, with possibly a wheeze expiratory +/- inspiratory
May be slightly prolonged expiratory phase Prolonged expiratory phase Regular even cycles
May be distressed, anxious Likely calm, may be mildly anxious Distressed, anxious, fighting for breath, exhausted, catatonic Calm, quiet
Crackles at bases, to mid-zone May have some fine crackles at bases Coarse crackles full field, with possibly a wheeze expiratory +/- inspiratory No crackles or scattered fine basal crackles, e.g. postural
100-120/min 60-100/min >120 or <60 as a late sign
Prolonged expiratory phase May be slightly prolonged expiratory phase Regular even cycles
May be altered Alert Altered or unconscious
Speaks in clear and steady sentences Speaks in sentences Speaks in short phrases only Speaks in words only or unable to speak
Little effort with small chest movement Marked chest movement with accessory muscles, intercostal retraction and/or tracheal tugging Marked chest movement and may be some use of accessory muscles May be slight increase in normal chest movement
Normal Pale and sweaty, may be cyanosed May be pale and sweaty
16-20/min >20/min 12-16/min >20/min or <8/min
May be distressed, anxious Distressed, anxious, fighting for breath, exhausted, catatonic Calm, quiet Likely calm, may be mildly anxious
Mild expiratory wheeze Usually quiet, no wheeze Expiratory wheeze, may also be inspiratory wheeze Expiratory wheeze, later may also be inspiratory wheeze and may have no breath sounds
May be pale and sweaty Pale and sweaty, may be cyanosed Normal
Marked chest movement and may be some use of accessory muscles Marked chest movement with accessory muscles, intercostal retraction and/or tracheal tugging May be slight increase in normal chest movement Little effort with small chest movement
Distressed, anxious, fighting for breath, exhausted, catatonic Calm, quiet Likely calm, may be mildly anxious May be distressed, anxious
Alert May be altered Altered or unconscious
Speaks in short phrases only Speaks in clear and steady sentences Speaks in sentences Speaks in words only or unable to speak
