A major cause of preventable cardiac arrest in children is trouble breathing called respiratory distress which can lead to respiratory failure.
Children with respiratory distress may have:
1. A faster than normal breathing rate,
2. A faster than normal heart rate,
3. They have to work hard to breathe (their nostrils flare when breathing in, the breast bone or skin above the collar bones or below the ribs is retracted when the child breaths in),
4. They make abnormal sounds when they breath such as an inspiratory stridor, wheezing, or grunting,
5. Skin that is cool and pale,
6. They may be anxious, irritable, or drowsy,
7. They may be sitting up and leaning forward.
The more severe the trouble breathing is, the worse those problems are.
When a child with a respiratory distress becomes unable to breathe adequately then respiratory failure is present and the child is at risk for cardiac arrest.
There are two important functions of breathing. The first is to supply oxygen to the blood which occurs during inspiration. The second is to get rid of carbon dioxide that builds up in the blood. This occurs during expiration.
Respiratory failure occurs when the patient’s breathing is inadequate to provide enough oxygen to the blood during inhalation or to eliminate enough carbon dioxide during exhalation.
A patient in respiratory failure has too little oxygen in his blood or too much carbon dioxide in his blood or both problems.
Doctors suspect respiratory failure when:
1. The child is breathing very rapidly (this occurs in early respiratory failure),
2. The child is breathing more slowly than normal (this occurs in late respiratory failure and means that the child is in danger of respiratory arrest and needs immediate treatment to help breathing),
3. The child’s heart rate is faster than normal (This occurs in early respiratory failure),
4. The child’s heart rate is slower than normal (This occurs in late respiratory failure and means that the child is in danger of cardiac arrest and needs immediate treatment to help breathing).
5. The child is working very hard to breath,
6. The child is taking very shallow breaths,
7. The child is not breathing at all (The doctor or parent begins immediate basic life support and activates the emergency system by calling 911 if outside the hospital or in the hospital calling a code blue (or the local term),
8. The child has bluish discoloration of the lips, or mucous membranes, or nail beds,
9. The child’s breathing when listening with a stethoscope is much softer than normal,
10.The child is very drowsy or completely unresponsive.
The next post will give the normal respiratory rates and heart rates for infants and children and the one after that will go over the causes and treatment of respiratory distress and respiratory failure.
Next blog: What the Pediatric Respiratory Rate, Pulse Rate, and Blood Pressure Means