Common Pediatric Respiratory Emergencies

Sometimes, it’s simply unavoidable: You find yourself in a situation where you have to bring your child to the emergency room. It’s never ideal, but it can be particularly stressful in the event of respiratory distress. After all, few things are more alarming than not knowing what to do when children have difficulty breathing – and it results in a great number of emergency pediatric visits each year.

While there are many reasons a child may need to visit the emergency room for a respiratory emergency, there are four prevalent conditions that we see the most often. Today, we’ll review what they are and how they can be treated.

Asthma

Asthma is diagnosed as a chronic condition in which a person’s airways become inflamed. This can lead to an asthma-related episode, typically defined by wheezing, coughing, chest tightness and shortness of breath. Throughout the United States, seven million children have asthma, leading to millions of emergency department visits each year.

Asthma episodes are triggered by an extreme response to particular stimuli. Not to be confused with upper respiratory infections, asthma, which stems from the lower airways, can be noted by specific symptoms: frequent episodes, wheezing bouts occurring following common triggers (i.e. exercise, allergens or tobacco smoke), respiratory symptoms that linger longer than 10days, family medical history, and/or a positive response to traditional asthma treatments can be indicators of asthma in children. That said, it can be difficult to obtain a true diagnosis, as it requires a good deal of cooperation and formal pulmonary function testing.

At Laredo Emergency Room, children with asthmatic symptoms are assessed quickly, with attentive observation and monitoring by our world-class staff. Patients’ oxygen saturation levels are continuously tracked to ensure a continuous flow. Our board-certified physicians will also administer effective treatments as necessary, including short-acting beta-agonist (SABA) treatment or, in the case of severe asthma, magnesium sulfate for its ability to improve airflow.

Croup

Most often found in children between the ages of six months and three years, this ailment is commonly identified by the unique, hoarse cough it generates. Many relate it to a seal bark, and it’s defined by upper airway inflammation and edema. Commonly caused by a virus, it’s typically accompanied by a runny nose and low-grade fever.

In the emergency room, the doctors will evaluate the days leading up to the event to help inform their diagnosis. For example, children with croup are likely to have had a fever or upper respiratory infection in the recent days prior. Sudden onset symptoms are typically not associated. Children with croup also otherwise appear to be well, rather than visibly sick. Additional testing may be ordered to rule out other potential diagnoses.

To treat croup at Laredo Emergency Room, the ABCs – or Airway, Breathing and Circulation – will be a top priority. In some cases, intubation will be necessary. Our expert pediatric emergency care teams will work to help you and your child stay calm, helping to diffuse respiratory distress as much as possible. From there, the appropriate medications will be prescribed for treatment and the majority of patients are safe to be discharged to recover at home.

Bronchiolitis

For children under two years old, bronchiolitis is both the most frequently seen lower respiratory tract condition and the leading cause of hospitalization among infants. It’s typically caused by a viral infection, RSV, leading to bronchiolar inflammation noted by wheezing or respiratory crackles. Bronchiolitis outbreaks tend to be seasonal, often appearing from late fall to early spring.

In the majority of cases, bronchiolitis remains a mild illness – albeit one that can linger for weeks – requiring no extraordinary treatment. However, as many as 20% of cases are associated with major complications including dehydration, hypoxemia, coinfection and respiratory failure, requiring immediate emergency care. For patients with severe symptoms, admission to the ICU or even ventilation may be necessary. Because of its potential for serious difficulties, or even death, emergency pediatric care is strongly recommended for children showing signs of bronchiolitis.

After a physician evaluation, proper treatment will be determined based on the severity. Nasal suctioning, for example, is one method that’s proven to be effective in improving respiratory conditions. IV hydration, respiratory monitoring and supplemental oxygen are other common treatments.

Pneumonia

Across the world, pneumonia remains the leading cause of child mortality, with cases exceeding 150 million each year. Due to its potential danger, parents commonly bring their children to the emergency room when they suspect pneumonia. And although it can be tricky to discern between other respiratory conditions, including asthma and bronchitis, the world-class pediatricians at Laredo Emergency Room are well-equipped to make an accurate diagnosis based on your child’s symptoms.

Classic pneumonia symptoms include fever, cough, chest palpitations and chest pain. For infants, who have less typical symptoms, it may appear as lethargy, loss of appetite or unexplained discomfort. In some cases, headache, vomiting and/or rash are present, as well. The physician will check the child’s breathing rate for any abnormalities, and to see if it appears to take extra effort to maintain breathing.

Treatment for pneumonia can vary greatly depending on the age of the child and the severity. As part of standard supportive care, the physician may apply supplementary oxygen, bronchodilators, or suctioning (in the case of infants). IV fluids may be given following an evaluation, as well. In rare cases, noninvasive ventilator support might be used to counteract respiratory failure. Patients will be continuously assessed for potential complications, such as sepsis or infectious spread, and assigned appropriate follow-up procedures out of an abundance of caution.

Asthma, croup, bronchiolitis and pneumonia may be the most common reasons for pediatric emergency room visits, but they’re not the only reasons to seek emergency medical attention for a child. It’s always important to stay alert at all times when caring for a child and know the signs of respiratory distress or a serious medical problem. For instance, a lack of oxygen often causes noticeable color changes – specifically a blue or white hue on the mouth or lips. If your infant or child is displaying any severe symptoms, respiratory or otherwise, it’s safest to bring them in to be seen by our pediatricians. And because we’re open and prepared 24/7/365 to help you and your family, emergency care is always available when you need it most.

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