ASSESS COUGH OR DIFFICULTY BREATHING

A child with a cough or difficulty breathing is assessed for:

1.  How long the child has had a cough or difficulty breathing
2.  Fast breathing
3.  Chest indrawing
4.  Stridor
5.  Wheezing 

 Why important assess for cough or difficult breathing

ASK: For how long has the child had a cough or difficulty breathing?
 

 A child who has had a cough or difficulty breathing for more than 2 weeks has a chronic cough. This may be a sign of tuberculosis, asthma, whooping cough or another problem.

 

 

 COUNT the breaths in one minute

 You must count the breaths the child takes in one minute to decide whether the child has fast breathing.

The child must be quiet and calm when you watch and listen to his or her breathing.

 

 2 months up to 12 months    50 or more breaths per minute

 12 months up to 5 years        40 or more breaths per minute

 A child who is exactly 12 months old has fast breathing if you count 40 or more breaths per minute.

LOOK for chest indrawing 

Lower chest wall indrawing is an indicator of pneumonia.Look for chest indrawing when the child breathes in.

In normal breathing, the whole chest wall (upper and lower) and the abdomen move out when the child breathes in. When chest indrawing is present, the lower chest wall goes in  when the child breathes in.

LOOK and LISTEN for stridor

Stridor is a harsh noise made when the child breathes in when there is a swelling of the larynx, trachea or epiglottis.This swelling interferes with air entering the lungs.

Put your ear near the child's mouth because stridor can be difficult to hear.

A child who has stridor when calm has a dangerous condition.

LOOK and LISTEN for wheezing

Wheezing is a soft musical noise made when the child is breathing out caused by a narrowing of the air passages in the lungs. Breathing out takes longer than normal and requires effort.

Hold your ear near the child's mouth because the wheezing noise can be difficult to hear.