Signs of Respiratory Distress in Children
Introduction[edit | edit source]
One of the most common reasons an infant is admitted to the neonatal intensive care unit is due to Respiratory distress[1]. Respiratory distress can be recognised as one or more signs of increased work of breathing which will be discussed below.
Signs and Symptoms[edit | edit source]
Below are the more common signs and symptoms and their causes:[2][3]
- Weak cry
- sign of fatigue and shows the child is prioritising energy expenditure for work of breathing.
- Grunting
- Increase positive end expiatory pressure (PEEP) by closing of the glottis (therefore increasing Functional Residual Capacity (FRC).
- Tachypnoea
- Unable to increase Tidal volume and therefore increase Respiratory rate.
- Cricoid Tug/Tracheal tug
- Increase pull of diaphragm is transmitted as a downwards tug on the trachea during inspiration.
- Sternal recession
- Due to high negative pressures on inspiration.
- Sub-costal and intercostal recession
- Due to high negative pressures on inspiration.
- Nasal flaring
- To help increase the diameter of the airway.
- Head bopping
- Due to high use of sternocleidomastoid and scalene muscles.
- Clammy
- Due to high energy expenditure to breathe therefore sweating to regulate temperature.
- Pallor
- Not oxygenating effectively.
- Cyanosis
- Dependent on haemoglobin and peripheral circulation-indicates poor oxygen saturation levels.
- Stridor
- Partial obstruction of upper trachea.
- Wheeze
- Narrowing or obstruction of the small airways by secretions or inflammation.
- Lethargy
- Being breathless and working hard causes discomfort and agitation. Also reserved energy fro work of breathing.
- Tachycardia
- to assist in oxygen transport.
- Hypoxemia
- reduced ability to oxygenate.
- Hypercarbia
- reduced ability to expire carbon dioxide.
How can Physiotherapy help?[edit | edit source]
The goals of physiotherapy is to help increase tidal volumes, help clear secretions, help improve oxygenation around the body and manage ventilation.[1]
- Manual techniques such as vibrations and percussion
- Postural drainage
- Saline and Suctioning (saline helps clear secretions)
- Therapeutic exercise
- Central Lavage
- Bronchoalveolar lavage (BAL)
- Use of various types of equipment to assist in respiratory care e.g. Acapella / PEP mask / Cough Assist devices.
- Education and advice on self management.
References[edit | edit source]
- ↑ 1.0 1.1 Reuter S, Moser C, Baack M. Respiratory distress in the newborn. Pediatrics in review. 2014 Oct;35(10):417.
- ↑ Taussig LM, Landau LI. Pediatric respiratory medicine. Elsevier Health Sciences; 2008.
- ↑ Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Paediatr Respir Rev. 2013 Mar; 14(1):29-36; quiz 36-7.