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Sequential Clinical Assessment of Respiratory Function (SCARF) Score
Sequential Clinical Assessment of Respiratory Function (SCARF) Score
Incentive spirometry <50% predicted
Respiratory rate >20/min
Numeric pain score ≥5
Inadequate/weak cough
Result0 points
Lower physiologic burden; reassess serially as fractures evolve.
When to use
- Serial bedside reassessment of pulmonary physiology in critically ill rib fracture patients to guide analgesia and respiratory therapy escalation.
Formula
1 point each for: incentive spirometry <50% predicted, respiratory rate >20, pain score ≥5, inadequate cough. Range 0-4.
Pearls and pitfalls
- Intended for repeated (not one-time) assessment — a rising score over time is itself a warning sign.