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Difficulty Breathing In Infants And Young Children An Evidence-Based Approach

October 2004

Difficulty breathing is a very common reason children come to EDs. While most cases are due to minor respiratory infections that resolve with supportive care, some children may have serious underlying pathology and progress to respiratory failure. Furthermore, the history can be elusive, resulting in potentially harmful delays in appropriate management. Perhaps most feared by the emergency physician is the initially wellappearing child who is having just a little difficulty breathing who unexpectedly and rapidly progresses to respiratory failure. Although this is not typical, respiratory failure can rapidly ensue in some instances and is the most common cause of cardiopulmonary arrest in children.1 Therefore, timely recognition and management are essential.

This review presents a logical approach to this rather large topic and discusses the most common pediatric respiratory emergencies. A detailed discussion of the entire spectrum of respiratory illness in children is beyond the scope of this text. Rather, it presents a systematic approach to management with careful attention to the relevant existing evidence.

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