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Breathing Problems in Children: When to Call 911

There’s nothing more frightening than a child struggling to breathe. There are many causes of breathing problems in children: pneumonia, asthma, allergies and foreign objects, just to name a few. Whatever the cause, having your child evaluated and treated by a physician as quickly as possible is paramount to a positive outcome. How do you know when breathing problems in children are an emergency and when they’re not? Because symptoms range between subtle and obvious, it’s sometimes difficult to tell.

Symptoms of Difficulty Breathing

A child with a cold will have different symptoms than a child with a foreign object stuck in their throat. Familiarizing yourself with a wide-range of symptoms will help you differentiate between mild symptoms and those that are life-threatening:1

  • Wheezing – high-pitched whistling sound.
  • Hoarseness – raspy quality of the voice.
  • Rapid breathing – breathing faster than normal.
  • A bark-like cough – almost sounds like a barking seal.
  • Nasal congestion – stuffy nose, runny nose.
  • Nasal flaring – nostrils open widely when breathing.
  • A bluish tint to the lips – called cyanosis; due to lack of oxygen.
  • Unequal rise of the chest wall – one side rises while the other remains flat.
  • Unusual sounds – grunting or gasping while breathing.
  • Using accessory muscles to breathe – small muscles in the neck, shoulders and between the ribs puff out when breathing.

When to Call 911

It’s always better to be safe than sorry. If you’re not sure if your child’s breathing problem is serious, no one will fault you for calling 911 if it turns out that it’s not. There are some signs and symptoms of respiratory distress in children that should always warrant emergency medical attention. According to WebMD, call 911 if your child:2

  • Appears very sick.
  • Is gasping for breath
  • Is unable to talk or cry because of difficulty breathing
  • Grunts when inhaling or exhaling
  • Has a bluish tint to their lips
  • Is breathing very fast.
  • May have an object stuck in their throat.

What to Do While Waiting for the Ambulance

The most important thing in any medical emergency, especially when it involves a child, is to remain calm. If your child sees that you’re upset, it will only increase their level of anxiety which may worsen their symptoms.

While waiting for the ambulance to arrive, implement the following steps:3

  1. Continuously monitor your child’s breathing and pulse. If necessary begin CPR.
  2. Place your child in a comfortable position that best provides relief. For some children, this may mean sitting fully upright. Others may benefit from leaning over a pillow while sitting in a chair. You’ll be able to recognize which position is most comfortable by the way your child reacts to it.
  3. Give prescribed medications, such as oxygen and a rescue inhaler, if applicable. Write down the time and dose of each medication, so you can pass it on to emergency responders.
  4. Remove tight clothing, especially around the neck, chest and back areas.
  5. Sometimes a well-ventilated room makes breathing easier. Open a window or point a fan directly toward your child’s face to decrease breathlessness.

Breathing problems in children should always be taken seriously. For more tips on how to manage them, talk to your pediatrician.


Author: Deborah Leader RN, BSN, PHN


1 Allergy and Asthma Network. Respiratory Diseases in Children under 5. Accessed 12/11/13.
2 WebMD. Breathing Problems in Children. Accessed 12/11/2013.
3 National Institutes of Health. Breathing difficulties; first aid. Updated Oct. 31, 2013.

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