Pediatric emergency medicine trisk 2370 2370
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e-TABLE 94.8
INFECTIOUS DISEASES SOCIETY OF AMERICA AND AMERICAN
THORACIC SOCIETY GUIDELINES FOR ASSESSING DISEASE
SEVERITY IN CHILDREN WITH COMMUNITY-ACQUIRED
PNEUMONIA a
Major
Minor
Invasive mechanical ventilation
Fluid-refractory shock
Acute need for noninvasive positive-pressure
ventilation
Hypoxemia requiring supplemental oxygen
concentration or flow beyond what is
feasible in a general ward setting
Tachypnea
Apnea
Increased work of breathing
Pao2 /FiO2 ratio <250
Multilobar infiltrates
PEWS score >6
Altered mental status
Hypotension
Presence of pleural effusion
Comorbid conditions (e.g.,
sickle cell anemia,
immunodeficiency, or
immunosuppression)
Unexplained metabolic
acidosis
a The
clinician should consider intensive care unit care for children with ≥1 major or ≥2 minor criteria.
PaO2 , arterial oxygen pressure; FiO2 , fraction of inspired oxygen; PEWS, pediatric early warning score.
