Abnormal Breathing Sounds
Considerations:
Children are at higher risk of airway obstruction because they have narrower airways than adults. In young children, stridor* is a significant sign of airway obstruction and must be treated immediately in order to prevent total airway obstruction.
* Stridor is an abnormal, high-pitched, musical breathing sound caused by a blockage in the throat or larynx (extrathoracic airway obstruction); usually heard when inhaling. Also, see wheezing and abnormal lung sounds. Stridor may indicate an emergency and should always be evaluated immediately by a health care provider.
The airway can be obstructed by an object, by swelling of the tissues of the throat or upper airway, or by spasm of the airway muscles or the vocal cords.
Common Causes:
- inhalation of an object such as a peanut or marble ( foreign body aspiration )
- laryngitis ( acute )
- airway trauma
- allergic reaction
- croup
- enlarged tonsils or adenoids (such as with tonsillitis )
- abscess on the tonsils
- inhalation injury (such as smoke inhalation)
- neck surgery
- neck or face swelling
- secretions, particularly phlegm (sputum)
- vocal cord cancer
- prolonged intubation (breathing tube)
- diagnostic tests such as bronchoscopy or laryngoscopy
Note: There may be other causes of stridor. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for stridor, occurring alone or in combination with other problems.
Home Care:
Follow prescribed therapy in treating the underlying cause. See also first-aid measures for choking.
Call Your Healthcare Provider If there is any indication of unexplained stridor, especially in a child.
What to Expect:
In emergency situations, vital signs (temperature, pulse , rate of breathing, blood pressure ) will be monitored and the Heimlich maneuver may be necessary. Then the medical history will be obtained and a physical examination performed. Intubation (insertion of a "breathing tube") may be necessary if there is inability to breathe properly ( respiratory failure).
Medical history questions documenting abnormal breathing sounds in detail may include:
- quality
Is the abnormal breathing sounds a high-pitched sound?
- time pattern
Did it begin suddenly?
- aggravating factors
Is it possible that the child may have put something in his (her) mouth and gotten it into their windpipe?
- Has the child been ill recently?
Other
- Is the child's neck or face swollen?
- Has the child been coughing or complaining of a sore throat ?
- What other symptoms are also present?
- Is there nasal flaring ?
- Is the child using their chest muscles to breathe ( intercostal retractions )?
- Does the child have blue lips, blue nailbeds, or bluish color of the skin?
The physical examination will include monitoring the vital signs and listening to the lungs.
Diagnostic tests that may be performed include:
.
- Arterial Blood Gas Analysis
- Bronchoscopy
- CT Scan, Thoracic
- Laryngoscopy
- X-ray of the chest
If you see this type of breathing DO NOT delay CPR. The person desperatly needs air and only you can provide it.
