Respiratory Distress in Infants

Building on my last post, I’ve found this youtube playlist of some short videos of infants in respiratory distress. From my year, so far(!), in Paeds ED, sepsis and respiratory problems have been the two most common medical reasons for admitting kids to PICU (ie the reasons why kids are big sick). And as winter comes round, there’ll be more and more bronchi kids

It’s really important to be able to recognise the seriously ill child, and if you can pick up on on these respiratory signs you’ll be doing pretty well. Before I add the links, just a quick point; we in the UK call the sucking in of various bits of the chest ‘recession’, but in the US they call it ‘retraction’.

So, here goes:

This is a really good example of ‘tracheal tug’; where there’s a big sucking in around the trachea. Really pronounced tracheal tug can be a sign of very severe respiratory distress. In adults with respiratory distress something you look for is someone who can’t speak in full sentences – this baby clearly cannot ‘speak’ in full sentences either.

In really small infants they ‘head bob’ because their neck extensor muscles are weaker than older kids.

This one’s particularly grim; it shows a small infant with horrendous sternal recession and tracheal tug. Sternal recession generally shows respiratory distress at a more advanced stage than intercostal and subcostal recession alone. These kids are often pretty sick. You can really hear the stridor as well

This video’s similarly unpleasant; it shows an older child with pretty much his whole chest sucking in (you can see this better at 00:14). This video appears to show the child being bagged.

None of these videos are particularly nice to watch, but they are very informative for any students doing paediatric placements.

And to make you feel better, here’s a video of a happy infant with puppies 🙂 

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