SOB doesn’t mean what you think! Respiratory distress signs you should know

Dr. Christina Johns, MD, MEd | October 03, 2018, 08:05 AM

I really like early fall—it’s still warm and nice out, my kids go back to school, and we return to our regular routine. But by mid-September, children have been in classrooms where viruses circulate and ragweed and other allergens fly through the air. The number of children with asthma, wheezing, croup and other respiratory illnesses starts to increase. Almost like clockwork, three weeks into the school year, healthcare practitioners see an uptick in kids with respiratory distress. We often shorten it to SOB: shortness of breath.

Since breathing difficulty can turn south in the blink of an eye, let’s review some signs of respiratory distress so you can recognize it sooner.

Rapid Breathing

While this is one of the primary signs, it’s important to consider what breathing rate is normal for a child’s age. For example, babies are comfortable at a rate of 40 breaths per minute, but that same rate in a 15-year-old would indicate significant distress.

Color Change

Someone turning blue or pale may not be oxygenating properly and is likely experiencing respiratory distress that needs to be assessed immediately. I want to emphasize that color change can be a serious late finding that breathing problems have been going on for longer or progressed more rapidly than realized.

Nasal Flaring

When nostrils flare or move in and out, it’s a sign that the body is working harder than normal to get oxygen into the lungs.

Grunting

This is more common in babies with shortness of breath. The grunting noise is the body’s effort to increase pressure in the lungs and keep them open to optimize oxygen exchange.

Retractions

Often described as “pulling” between the muscles in the chest, it can occur above the sternum, between the ribs, or just below the ribcage, and is another way of maximizing oxygen delivery into the body.

Noisy Breathing

Any extra breathing sound, whether wheezing, a grating sound or a bark-like cough, needs to be investigated.

Mental Status

A late and ominous finding, as respiratory distress progresses to respiratory failure, increased confusion and/or sleepiness can occur as oxygen delivery to the brain decreases.

Use this helpful list to recognize respiratory distress easier and earlier, so you can get back to enjoying the beautiful season.

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About the Author - Dr. Christina Johns, MD, MEd

Christina Johns, MD, MEd is author of the Dear Dr. Christina blog and the Senior Medical Advisor at PM Pediatrics, the specialized urgent care just for kids from cradle through college. As a parent, pediatrician and pediatric emergency physician with a master’s in education, she shares her own expertise, plus the wealth of knowledge from the network’s highly skilled staff, with patients and families everywhere.

Get everyday health tips, insightful articles and more at deardrchristina.com

PM Pediatrics in Annapolis is located at 2301A Forest Dr., in the Festival at Riva Shopping Center. Open every day until midnight, there’s no appointment needed, and most insurance is accepted. Visit pmpediatrics.com to learn more.