2. Respiratory distress in paediatrics
Recession, sub costal, intercostal, suprasternal and
supraclavicular
• Areas sucked inward during inspiration, due to pressure
changes and lack of thoracic stability
Increased respiratory rate (tachypnoea) greater than
60bpm
• Shallow rapid breathing
• Aim is to increase the minute ventilation
Head bobbing
• Attempt to use accessory respiratory muscles but unable
to fix
Nasal flare
• Dilatation of the nostrils using the dilatores naris muscle
• Primitive way to entrain more air
4. Respiratory distress continued
Expiratory granting(auto PEEP)
• Trying to increase intrinsic PEEP and reduce work
of breathing
• Aim is to increase Functional Residual Capacity
See sawing
• forceful contraction of the diaphragm, causes
abdomen to pushed out and generates massive
negative pressure in thorax, sucking chest wall in.
Apnoea
• Chid is fatiguing and requires urgent respiratory
support and stimulation
6. Respiratory Distress continued
Wheezing
• A tight, whistling or musical sound heard with
each breath may indicate that the air passages
may be smaller (tighter), making it harder to
breathe.
Cyanosis, especially central cyanosis (lips
and tongue
Stridor
• Obstruction of upper airways
9. Respiratory distress in adults
Tachypnoea respiratory
• Respiratory rate greater than 20bpm
Nasal flaring
Grunting
Dyspnoea and use of accessory muscles to
breath
Recessions, subcostal, intercostal, suprasternal
and supraclavicular
Stridor
wheezing
12. References
Berverly Harden at al, Respiratory
Physiotherapy, 2009, Edinburgh London New
York Oxford Philadelphia.
http://medicalcenter.osu.edu/patientcare/he
althcare_services/
http://www.livestrong.com/article/501075-
signs-symptoms-of-respiratory-distress-in-
infants/