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