ToolsCalculators
Respiratory Distress Observation Scale (RDOS)
Observational measure of dyspnoea severity for patients unable to self-report.
Respiratory Distress Observation Scale (RDOS)
Heart rate
Respiratory rate
Restlessness (non-purposeful movements)
Accessory muscle use (rise in clavicle on inspiration)
Paradoxical breathing (abdomen moves in on inspiration)
Grunting at end-expiration
Nasal flaring
Look of fear (eyes wide, brow and facial tension, mouth open)
Result0 points
Score below 3 makes significant respiratory distress unlikely.
- RDOS (range 0-16)
- 0
When to use
- Assessing dyspnoea severity in patients who cannot reliably self-report (advanced dementia, delirium, near end of life, or deep sedation).
- Trending response to symptom-directed therapy (opioids, positioning, supplemental oxygen) over time.
Formula
Sum of 8 observed items (heart rate, respiratory rate, restlessness, accessory muscle use, paradoxical breathing, grunting, nasal flaring, look of fear), each scored 0, 1, or 2. Range 0-16.
Pearls and pitfalls
- A cut-off of >=3 was associated with patient-reported dyspnoea and nearness to death in the original validation cohort.