During the initial evaluation, airway sounds (eg, stridor, wheezing, snoring) must be differentiated. (For audio of various breath sounds, go to: https://www.practicalclinicalskills.com/breath-sounds-reference-guide/.) Stridor is a high-pitched sound most commonly heard on inspiration, and, in most cases, can be heard without a stethoscope. Wheezing is most often heard on expiration, and auscultation typically requires a stethoscope. Careful observation of the phases of respiration is necessary to differentiate inspiratory and expiratory sounds. Stertor (snoring) is a low-pitched sound, and is most commonly heard with nasal or nasopharyngeal obstruction. Parents often mislabel these airway sounds, so information from witnessing prehospital providers should be elicited if the patient has improved en route.3
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