Respiratory retraction: supraclavicular, intercostal, subcostal. Respiratory effort: mild, moderate, severe, inspiratory/expiratory ratio, shortness of breath. Respiratory rate, rhythm and depth (shallow, normal or deep). Adventitious Breath Sounds: Stridor, Wheezes / Rhonchi, Crackles / Rales and Pleural Rub | (Ausmed Jan 20, 2020). Atopic diseases such as asthma, hay fever and eczema. Infectious diseases such as tuberculosis (remember high-risk groups). Respiratory diseases with a genetic component - eg, cystic fibrosis, emphysema (alpha-1-antitrypsin deficiency). Onset and duration of signs and symptoms,. 
awake, alert, responsive to sound & verbal command. condition of lips, mouth & nose, excessive drooling, difficulty swallowing. The very young are at risk for hypothermia, they may require additional warmth. Providing a quite, warm and comfortable environment will likely improve the quality of the assessment. The nurse must adapt techniques to match the child's age and developmental level while systematically assessing the child's compete physical condition. Genetic conditions such as cystic fibrosis.Īssessing respiratory function in young children can be challenging. Lower respiratory infections such as pneumonia and bronchiolitis īacterial infections such as bacterial pneumonia or tuberculosis Upper respiratory infections such as croup and influenza The following are some common causes of respiratory distress in children. Their chest walls are more compliant and children rely heavily on their diaphragm (Saikia & Mahanta 2019 RCHM n.d.).Ĭauses of Respiratory Distress in Children They have soft, horizontally sloped ribs and poorly developed intercostals. Due to these differences, a child’s airway is much easier to occlude than an adult’s (Saikia & Mahanta 2019).Ī child’s upper and lower airways are also smaller than adults, and their lungs are not fully developed. They also have large tongues in a small mouth and the trachea is shorter and more compliant. Infants have larger heads and occiputs relative to their body size therefore the head is naturally flexed in the supine position. A vascular ring is a rare birth defect in which a large blood vessel in the heart - the aortic arch - encircles and squeezes the trachea and esophagus.Assessing a Child Well-Child Respiratory Assessment Tips MRI/MRA is rarely requested but it is helpful in diagnosing the presence of a vascular ring. Magnetic resonance imaging or magnetic resonance angiography - An imaging test that shows soft tissues in great detail. Plain X-ray, airway fluoroscopy, barium swallow, and CT scan of the chest - Films that can help the doctor further evaluate the noisy breathing. 
Flexible laryngoscopy - A test in which the doctor passes a tiny tube with a camera and light at the end through the nose and into the airway to look for problems.The airway doctor may recommend one or more of these diagnostic tests: Once the child is determined to be stable, the physician will evaluate specific features of the stridor (inspiratory, expiratory, biphasic) and voice.
The doctor's physical examination begins with an assessment for signs of respiratory distress (nasal flaring, retractions, color change, etc.).
Important history will include questions regarding the onset, duration and progression of stridor as well as associated feeding or voice disturbances. The evaluation of stridor begins with a history and physical examination of your child.
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