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Pulmonary Index Score (PIS)

Pulmonary Index Score (PIS)
Score Respiratory rate Wheezing Inspiratory/
expiratory ratio		 Accessory muscle use Oxygen saturation
<6 years old ≥6 years old
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 12.0