Featured Expert: Many parents spend the first few years of their child’s life closely monitoring their breathing—listening for new or unusual sounds. These sounds may include wheezing, congestion or rough breathing that can be difficult to decode. "It's important for parents to realize that
breathing noises mean different things and these sounds sometimes point to a serious health issue," says Jonathan Walsh, M.D., an expert in pediatric care for ears, nose and throat. Changes in breathing sounds can be scary for parents, yet noisy breathing is remarkably common among infants and toddlers. "Children's airways are softer and narrower than adults', so they're more prone to make loud breathing noises," Walsh says. "But not all noisy breathing is equally concerning—and some of these sounds will resolve on their own over time." Here's how the three distinct noises break down:
Pediatric OtolaryngologyOur pediatric otolaryngologists provide compassionate and comprehensive care for children with common and rare ear, nose, and throat conditions. As part of the Johns Hopkins Children's Center, you have access to all the specialized resources of a children's hospital. When to See a Specialist for Noisy Childhood BreathingFiguring out the cause of noisy breathing isn't clear-cut. Parents and primary care providers may not be able to differentiate between wheezing, stridor and stertor in an infant or young child by exam alone. Diagnosing the problem often requires a thorough evaluation of the lungs and airway. "Most of the time, noisy breathing is not dangerous and will resolve without treatment, Walsh says. "If noisy breathing doesn't quiet down after an illness has passed, or if it goes away and comes back, the child should be evaluated by a specialist." The specialist may perform a variety of tests to determine the source of noisy breathing. A few of the most common:
Medical Treatments for Children with Noisy BreathingTreatment for noisy breathing depends on the underlying cause. A child who is sick and wheezing, for example, may be less concerning than a child who has wheezing that stems from both lungs without any noticeable illness. Successful treatment often hinges on having a team of professionals, including an ear, nose, and throat specialist; a pulmonologist; a gastroenterologist; and sometimes a cardiologist. Doctors may take a "wait-and-see approach," while providing children with supportive care such as a nebulizer (a device that turns liquid medicine into a mist that can be inhaled) to help them breathe easier. Other cases call for immediate surgery. "If your child is struggling to breathe or showing signs of labored breathing, such as bluish hue on the lips, skin or body or the chest collapsing inward, call 9-1-1 or take your child to the nearest emergency room," notes Walsh. Questions your doctor will ask that will inform your child's treatment:
What is the best location for assessing breath sounds in the pediatric patient?Evaluate the child's breath sounds along both the anterior and posterior chest walls. Listen for one full cycle of inspiration and expiration in all chest areas.
When caring for a toddler with epiglottis the nurse should first?If the medical team suspects epiglottitis, the first priority is to ensure that your or your child's airway is open and that enough oxygen is getting through. The team will monitor your or your child's breathing and blood oxygen level. If oxygen saturation levels drop too low, you or your child may need help breathing.
Which site should the nurse assess to obtain the pulse rate for a 1 year old child?The best spot to feel the pulse in an infant is the upper am, called the brachial pulse. Lay your baby down on the back with one arm bent so the hand is up by the ear.
When assessing for pain in a toddler which method would be the most appropriate?The best way to assess pain in babies is to observe how they behave. The FLACC (faces, legs, activity, cry, consolability) scale is an easy-to-use tool that helps measure pain in children who are too young to talk.
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