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RESPIRATORY DISTRESS/FAILURE

RECOGNIZE


In its simplest form, respiratory distress is a condition in which pulmonary activity is insufficient to bring oxygen to and remove carbon dioxide from the blood. Challenge arises with the recognition of respiratory distress when the patient appears to be breathing, but is not actually breathing effectively. Proper rate and depth of breathing is important to assess when evaluating whether a patient is effectively breathing. The two main actions involved in breathing are ventilation and oxygenation. Consider the signs and symptoms presented below:

Recognize respiratory distress/failure


ABNORMAL BREATH SOUNDS


STRIDOR
  • Upper airway obstruction (Foreign body)
GRUNTING
  • Upper airway obstruction (Swollen airway)
  • Pneumonia (grunting to recruit alveoli)
WHEEZING
  • Lower airway obstruction (Asthma)
CRACKLES
  • Fluid in lungs (Wet), Atelectasis (Dry)
ABSENT/DECREASED BREATH SOUNDS
  • Collapsed lung (Air, blood)
  • Lung tissue disease (Pneumonia)

In some instances, breath sounds can provide information about the source of the breathing problem.


CAUSES OF RESPIRATORY DISTRESS/FAILURE


Respiratory distress or failure generally falls into one of four broad categories: upper airway, lower airway, lung tissue disease, and CNS issues. This list is not comprehensive and specific conditions should be addressed with specific therapy, but these represent the most common causes of respiratory distress or failure in a pediatric population.

UPPER AIRWAY LOWER AIRWAY LUNG TISSUE DISEASE CNS ISSUES
  • Croup (swelling)
  • Foreign body
  • Retropharangeal abscess
  • Anaphylaxis
  • Bronchiolitis
  • Asthma
  • Pneumonia
  • Pneumonitis
  • Pulmonary edema
  • Overdose
  • Head trauma