These signs must be assessed when the child is calm and not crying:
- Stridor is usually due to viral croup.
- Indrawing of the lower chest wall may occur with most severe lower respiratory tract problems, i.e. pneumonia, stridor, bronchiolitis or asthma.
- Wheezing suggests bronchiolitis (in an infant) or asthma (in an older child).
- Fast breathing suggests pneumonia, bronchiolitis or asthma.
Older children with a severe lower respiratory tract problem may complain of shortness of breath. Always look for danger signs in any child with breathing difficulty.
The sudden onset of stridor or wheeze in a well child suggests a foreign body.
If any of these signs are present, the child should be carefully examined and considered for urgent transfer to hospital.