Breathing Emergency? How to Recognize and Respond to Respiratory Distress

Respiratory illness season is here. While most childhood illnesses are minor, there are times when a child's breathing can become compromised. How can you recognize and respond to breathing emergencies in children?

Our emergency medicine experts help you understand the signs of a breathing emergency in children and when to get immediate medical attention.

Understanding a child’s respiratory system

Children's respiratory systems are still developing, making them more likely to have breathing difficulties and go into respiratory distress. Their airways are smaller and more easily blocked. Kids also have increased metabolic demand (greater need to exchange oxygen and carbon dioxide) and less reserve than adults.

Recognize these signs of a breathing emergency in children:

Look for:

Rapid breathing: A child's normal breathing rate varies with age. If your child's breathing is faster than usual, especially if they have other symptoms, it could be a sign of a problem. On the other hand, a child who was distressed who is now breathing unusually slow may be in a worsening condition.
Labored breathing: If your child is struggling to breathe, wheezing, or making noises while breathing, this is also a problem. You may also notice your child's chest retracting (sucking in) between the ribs or above the collarbone. This is very common with viruses such as RSV.
Wheezing: A whistling or high-pitched sound during breathing, especially when breathing out.
Grunting: A sound made when your child exhales, which means they’re working hard to breathe.
Stridor: A high-pitched sound during inhaling, often accompanied by a barky or seal-like cough. May be a sign of croup.
Nasal flaring: When a child's nostrils flare out with each breath
Skin color changes: If the lips, fingertips or toes turn blue, this may mean low blood oxygen levels.
Altered consciousness: Drowsiness, confusion, or lethargy can indicate a serious breathing problem.

If your child is experiencing any of these signs of respiratory distress, call 911 immediately:

Breathing stops, especially if otherwise labored
Unresponsive
Lips, face, fingertips and toes are blue
Trouble speaking or making sounds
Chest muscles are retracting, or sucking in

What to do while waiting for help or the ambulance:

Keep calm: Your child will sense your fear and anxiety, so try to remain calm and reassuring, as frightened as you may be in the moment.
Keep them comfortable: If they are sitting up, try to keep their head and neck supported.
Stay with them: Do not leave them alone, no matter what
Continue to monitor their breathing

What causes breathing emergencies in children?

Asthma: This chronic condition causes inflammation and narrowing of the airways, making it difficult to breathe.
Bronchiolitis: A common respiratory infection in infants and toddlers, typically caused by the respiratory syncytial virus (RSV). Not to be confused with “bronchitis.”
Croup: An infection that causes swelling in the larynx, trachea, and bronchi, producing a characteristic "barking" cough.
Whooping cough: Also called pertussis, it’s back on the rise. Vaccination is the best prevention.
Foreign body aspiration: When a small object, such as food, toy, or button battery, becomes lodged in the airway.
Anaphylaxis: A severe allergic reaction that can cause airway swelling and breathing difficulties.

This guide is for informational purposes only and should not be considered a substitute for professional medical advice. If you are ever concerned about your child's breathing, it is always best to seek immediate medical attention or call 911.

Remember, every second counts, and early intervention can make a significant difference in a child's outcome.