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Criteria for Respiratory Distress in Pediatric Patient with Pneumonia

Purpose: To evaluate a pediatric patient community-acquired pneumonia (CAP) for signs of respiratory distress as listed by Bradley et al.

Description

A pediatric patient with community-acquired pneumonia (CAP) may show signs of respiratory distress. These can help to identify a patient who needs more aggressive management. The authors are from the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.


 

Patient selection:pediatric patient with community-acquired pneumonia (CAP)

Criteria for respiratory distress:

(1) tachypnea based on age (see below)

(2) dyspnea

(3) retractions (subcostal, supersternal, intercostals)

(4) grunting

(5) nasal flaring when breathing

(6) apnea

(7) altered mental status (lethargy, stupor, coma)

(8) oxygen saturation < 90% on room air by pulse oximetry

 

Age in years

Tachypnea

0 to 2 months

> 60 breaths per minute

2 to 12 months

> 50 breaths per minute

1 to 5 years

> 40 breaths per minute

> 5 years

> 20 breaths per minute

 

The WHO pocket book also uses:

(1) cyanosis or gasping

(2) inability to eat or dirnk

(3) abnormal chest auscultation findings

(4) convulsions

(5) stridor

(6) head nodding (head moves synchronously with inspiration)

 


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Specialty

Objective

ICD-10