Respiratory distress management in paediatric care

Respiratory system in the human body starts from the nose, pharynx [throat], windpipe opening [glottis], wind pipe [trachea, bronchus] and its branches [bronchioles] to the lungs full of alveoli, which are grape-shaped. A disease of any part of the respiratory system due to swelling, or obstruction or compression or aspiration; this is going to give you respiratory distress.

Few other medical problems of the heart, brain or even fever can also trigger respiratory distress. A Senior Consultant, Paediatricians and Neonatal Intensivists, shares some signs and symptoms of respiratory distress in children.

How will you come to know?
When you see a child or a person breathing faster, if breathing is deeper with or without retractions in the chest, in rib cage or upper abdomen or neck; with or without different kind of audible breath sounds associated with fatigue and sweating, should be considered as alarming sign to approach closest casualty and find immediate treatment.

Why does this happen?

The human body is made up of cells. Our cells need oxygen to stay alive and to remove carbon dioxide from the blood by breathing. This normally happens with the use of diaphragm unconsciously throughout the day in a normal healthy child or person. But due to any medical diseases, if enough oxygen does not reach to the cells, due to increased utilisation or decreased supply; or if lungs are not able to remove carbon dioxide, it leads to change in blood pH level.

Thereby, using all backup accessory muscles as auto compensatory mechanisms; our body tries to meet increased demand or decreased supply to prevent tissue death. This reflects through rapid breathing, deep rasping, with retractions, nasal flaring and audible noisy breath sounds sometimes. Untreated severe respiratory distress can lead to cardiac arrest if not treated in time.

What are the common medical problems leading to respiratory distress?
Respiratory Distress can happen due to various medical conditions like pneumonia, pleural effusion, lung malignancies, acute exacerbation of asthma, bronchitis and lung abscess, presence of foreign bodies in the respiratory system, severe laryngitis, peritonsillar abscess and others.

What can be done?
An obvious next step upon experiencing or witnessing respiratory distress is rushing the child to the nearest emergency room. Treatment is to supplement oxygen, to reduce work of breathing; followed by investigations to find the cause of respiratory distress by X-ray, blood tests and USG. Treatment depends on the cause. Many patients with respiratory distress not only require hospitalisation, but also monitoring in pediatric or adult ICU, and sometimes even ventilator care, if the disease evolves rapidly and severely.

Which age groups are more susceptible?
Respiratory distress can happen due to infections as well as be a part of a generalised illness, due to non-infectious diseases. Susceptibility for respiratory tract infection depends on the type or nature of infection and host response. Children can be protected against vaccine-preventable diseases if vaccinated in time adequately. But younger children have a low threshold to deteriorate, compared to older children or adults.

Most respiratory diseases are acute, screening is not required. But when you see your child breathing at a faster rate, deep rapid or laboured breathing, you should seek consultation by a doctor. Don’t delay, if the child’s distress progresses faster and further, reversibility will be slow and difficult. Here is how you can take care of respiratory distress.

this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     
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