A little while ago we had a little one come in who seemed unwell, but not horribly sick. She was only a couple of weeks old, but she was a bit snuffly and wasn’t feeding very well because she found it difficult to breath and feed at the same time.
We didn’t have any immediate concerns but were going to admit here to help with the feeding and give her a bit of a suction when we were free to clear her out.
An hour or so late, obs were done on the child and she was found to be in severe respiratory distress with sternal, subcostal and intercostal recession (see video below for an example), and oxygen saturations in the low 80s.
She didn’t respond to positive pressure, and when an infant of this age has to work so hard they tire quickly and their respiratory distress can turn into respiratory arrest. Before she got that point we had to assist her in her breathing by bagging her (using a bag valve mask) and then by breathing for her by intubation her. She was admitted to PICU and made a full recovery, but even so, to go from concern for feeding to severe respiratory distress in an hour without someone paying much attention is a little worrying.
Good on the parents for bringing this kid in. If they’d waited another few hours, the outcome could’ve been very different.