Emergency evaluation and immediate management of acute respiratory distress in children
- Debra L Weiner, MD, PhD
Debra L Weiner, MD, PhD
- Assistant Professor of Pediatrics
- Harvard Medical School
- Section Editor
- Gary R Fleisher, MD
Gary R Fleisher, MD
- Editor-in-Chief — Adult and Pediatric Emergency Medicine
- Section Editor — Pediatric Signs and Symptoms
- Egan Family Foundation Professor
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Respiratory distress is one of the most common chief complaints for which children seek medical care. It accounts for nearly 10 percent of pediatric emergency department visits and 20 percent of hospitalizations .
Respiratory distress in children, particularly neonates and infants, must be promptly recognized and aggressively treated because they may decompensate quickly. Factors that contribute to rapid respiratory compromise in children include smaller airways, increased metabolic demands, decreased respiratory reserves, and inadequate compensatory mechanisms as compared to adults. Respiratory arrest is the most common cause of cardiac arrest in children and outcomes are poor for patients who develop cardiopulmonary arrest as the result of respiratory deterioration [2-5].
The initial assessment and stabilization of children with respiratory and circulatory distress including airway management techniques, rapid sequence intubation (RSI), causes of respiratory compromise in children, and conditions causing respiratory distress in newborns are discussed separately:
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- DIFFERENTIAL DIAGNOSIS
- Initial rapid assessment
- Physical examination
- - General observation
- - Vital signs
- - Breathing
- - Other organ systems
- Ancillary studies
- - Bedside evaluation
- - Laboratory testing
- - Imaging
- DIAGNOSTIC APPROACH, IMMEDIATE MANAGEMENT
- Impending respiratory arrest
- Other respiratory distress
- - Trauma
- - No trauma
- SUMMARY AND RECOMMENDATIONS