Is this your symptom?
- Trouble breathing means working hard to breathe
- Normal breathing should be easy and quiet
Trouble Breathing: Symptoms
Trouble breathing is a reason to see a doctor right away. Here are symptoms to watch for:
- Struggling for each breath or short of breath
- Tight breathing so that you can barely speak
- Ribs are pulling in with each breath (called retractions)
- Breathing has become noisy (such as wheezing)
- Breathing is much faster than normal or there are long pauses in breathing (apnea attacks)
- Lips or face turn a blue color
- Breathing trouble gets worse fast
- Other symptoms, such as chest pain or coughing up blood.
- Your usual breathing treatment(s) are not working.
Trouble Breathing: Importance
- Trouble breathing is one of the most common reasons for getting admitted to the hospital.
- Many of these people need oxygen.
- Frail older people may get worse quickly.
Causes of Trouble Breathing
Trouble breathing comes from problems in the lower throat, voice box, windpipe, or lung airways. It can also be due to heart problems and other underlying conditions. Here are the common ones:
- Anaphylaxis(severe allergic reaction). Suspect when there is a sudden onset of trouble breathing and widespread hives. Common causes are bee stings or food allergies such as peanuts. This can be life threatening and needs immediate treatment. Call 911 .
- Asthma. Symptoms of an asthma attack are wheezing, a cough, and trouble breathing. If your asthma symptoms are severe or getting worse, go to ER.
- Bronchiolitis or RSV. A viral infection of the smallest airways in the lungs. Main symptoms are fast breathing and wheezing.
- COVID-19. Some patients develop breathing trouble with COVID-19 infection. This may or may not be severe.
- Cystic Fibrosis is a disease which causes severe damage to the lungs and other organs. Coughing and trouble breathing are main symptoms.
- Chronic Obstructive Pulmonary Disease (COPD) is from long-term inflammation of the airways which hampers airflow in and out of the lungs. The most common cause is smoking, but there are other causes. The problem gets worse slowly over time, but is treatable. Symptoms include cough, sputum and breathlessness.
- Epiglottitis (very serious) is a bacterial infection of the flap of tissue above the vocal cords. It normally covers the windpipe during swallowing. The main symptoms are severe sore throat, drooling, spitting and fever. It can shut off the airway. Call 911 .
- Foreign Object in Airway. Suspect this when there is a sudden onset of coughing and choking.
- Influenza. Main symptoms are a fever with a runny nose, sore throat, and bad cough. The flu virus can also cause problems such as pneumonia. Vaccine may prevent the disease.
- Pneumonia (serious) is a more serious infection of the lower parts of the airway (in the lung). It can be caused by viruses or bacteria. Symptoms include cough with brown or bloody mucus, breathlessness, chest pain and fever. Antibiotics may be needed to treat it.
- Whooping Cough is a bacterial infection of the airway. Main symptoms are long coughing spells and choking. Very serious in infants. Can be prevented by vaccine.
- Heart Failure (serious) occurs when the heart is not pumping as well as it should. Fluid can build up on the lungs and other parts of the body. The main symptoms are shortness of breath, swelling and tiredness. Sudden shortness of breath and a cough with frothy pink mucus can also occur, often at night.
- Pulmonary Embolus (serious) occurs when a clot from somewhere in the body (often the legs) travels around with the blood flow and is trapped in the lungs. A large clot can be life threatening. Symptoms include breathlessness, chest pain and coughing up blood.
- Lung Cancer (serious) is one of the main causes of death from cancer worldwide. People who smoke are at most risk. People who have worked in smoke-filled places (clubs and bars) are also at risk. Cough is a common symptom. If you have a new cough that does not go away within 3 weeks or if you are coughing up blood, see your doctor.
- Pneumothorax is a lung can collapse from a chest injury, lung problems or for no clear reason. Oxygen can't get into the collapsed part of the lung and the person has trouble breathing. Severity depends on how much of the lung has collapsed. It may need treatment in hospital to reinflate the lung. This can be life threatening and the breathing trouble gets worse very fast.
When to Call for Trouble Breathing
Call 911 Now
Go to ER Now
Call Doctor or Seek Care Now
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Contact Doctor Within 24 Hours
Contact Doctor During Office Hours
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Call 911 Now
- Severe trouble breathing (struggling for each breath, can barely speak)
- Stopped breathing or long pauses between each breath
- Passed out or feeling like you are going to pass out
- Lips or face are bluish when not coughing
- Confused
- Choking on a small object that could be caught in the throat
- Trouble breathing started suddenly after bee sting, new medicine or an allergic food
- Pain in the chest, neck or jaw
- You think you have a life-threatening emergency
Go to ER Now
- Loud wheezing (tight sound with breathing out)
- Stridor (harsh sound with breathing in)
- You have travelled a long distance (flight, car) or been bedridden in the past few weeks
- Trouble breathing started right after an injury to the chest
- Coughing up blood
- Breathing is getting worse fast
- Lips or face turn bluish when coughing
Call Doctor or Seek Care Now
- Fever or chills; feeling hot or shivery
- Soft wheezing (high-pitched, squeaky sound with breathing out)
- Breathing is much faster than normal
- Sharp chest pain when you take a deep breath
- You are pregnant, gave birth in the past 6 weeks or take estrogen (for hormone replacement or birth control)
- You, or a family member, have a history of blood clots
- Any part of your leg has become swollen and painful for no clear reason
- Weak immune system. Examples are: diabetes, sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, kidney problems.
- You are having cancer treatment or have recently been in hospital for care
- Your usual breathing treatment has not helped as it normally would
- Nonstop coughing and not able to sleep or do normal activities
- You feel weak or very sick
- You think you need to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Breathing trouble is not severe, but is not getting better within 24 hours or is getting worse
- You wake up short of breath in the night or get short of breath when you lie down
- You think you need to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Breathing trouble (not severe) that happens once in a while or often
- Mild breathing trouble that is getting better
- You have other questions or concerns
Care Advice for Stomach Pain
What You Should Know About Stomach Pain:
- Mild stomach pain can be caused by something simple. It could be from gas pains or eating too much.
- Sometimes, stomach pain signals the start of a viral infection. This will lead to vomiting or loose stools.
- Watching your child for 2 hours will help tell you the cause.
- Here is some care advice that should help.
Lie Down:
- Have your child lie down and rest until feeling better.
Clear Fluids:
- Offer clear fluids only (such as water, flat soft drinks or half-strength Gatorade).
- For mild pain, offer a regular diet.
Prepare for Vomiting:
- Keep a vomiting pan handy.
- Younger children often talk about stomach pain when they have nausea. Nausea is the sick stomach feeling that comes before they throw up.
Pass a Stool:
- Have your child sit on the toilet and try to pass a stool.
- This may help if the pain is from constipation or diarrhea.
- Note: for constipation, moving a warm wet cotton ball on the anus may help.
Do Not Give Medicines:
- Any drug (like ibuprofen) could upset the stomach and make the pain worse.
- Do not give any pain medicines or laxatives for stomach cramps.
- For fever higher than 102° F (39° C), acetaminophen (such as Tylenol) can be given.
What to Expect:
- With harmless causes, the pain is most often better or gone in 2 hours.
- With stomach flu, belly cramps may happen before each bout of vomiting or diarrhea. These cramps may come and go for a few days.
- With serious causes (such as appendicitis), the pain worsens and becomes constant.
Call Your Doctor If:
- Pain becomes severe
- Constant pain lasts more than 2 hours
- Mild pain that comes and goes lasts more than 24 hours
- You think your child needs to be seen
- Your child becomes worse
Extra Help - Worried Stomach:
- Help your child talk about events that trigger the stomach pain. Talk to your child about how to cope with these the next time around.
- Help your child worry less about things she can't control.
- To treat the pain, help your child get very relaxed. Lying down in a quiet place and taking slow deep breaths may help. Make the belly go up and down with each breath. Then try to relax all the muscles in the body. Think about something pleasant. Listening to audios that teach how to relax might also help.
- Make sure your child gets enough sleep.
- Make sure that your child doesn't miss any school because of stomach pains. Stressed children tend to want to stay home when the going gets rough.
- Caution: your child should see her doctor for an exam. Do this before concluding frequent stomach pains are from worrying too much.
