Warning Signs of Respiratory Distress

Medically Reviewed By William C. Lloyd III, MD, FACS
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baby using nebulizer
  • Respiratory distress is a medical emergency. Your body relies on your respiratory system to supply the oxygen necessary for your organs to function. If you are struggling to breathe, your body may not get enough oxygen, and without enough oxygen, critical organs shut down.

    Learning to recognize the signs and symptoms of respiratory distress in infants, children and adults may help you protect the lives of your loved ones. If you notice any of these symptoms, call 911 or seek immediate medical attention.

  • 1
    Rapid breathing
    young woman with hand on chest and concern on face and trouble breathing

    At rest, most adults breathe 12 to 20 times per minute. Infants inhale and exhale approximately 30 to 60 times per minute, and children, between 24 to 30 times per minute. A person who is breathing more rapidly than normal, for no apparent reason, may be experiencing respiratory distress. 

    An increased respiratory rate is the body’s way of attempting to pull additional oxygen into the body. However, unless the underlying causes of respiratory distress are addressed, the situation will likely get worse instead of better.

  • 2
    Shortness of breath
    worried mother comforting daughter wearing oxygen mask in hospital

    People who are experiencing respiratory distress often feel as if they can’t get enough air. It’s normal to feel short of breath when you exert yourself more than normal—say, when you run to catch a bus—but if you (or anyone else) feels short of breath at rest, something may be wrong.

    Sudden shortness of breath is particularly alarming. Call 911 if someone develops shortness of breath for no apparent reason.

  • 3
    Bluish lips or skin
    nurse supporting sick senior woman with oxygen mask and pale skin, bluish lips (cyanosis)

    We all know the lips and skin can take on a bluish color when we’re cold. Low temperature causes the blood vessels to shrink at the extremities. (That’s why kids often develop blue lips after swimming in cold lakes.) But a lack of oxygen can also cause the skin and lips to look blue. Here’s why: red blood cells carry oxygen throughout the body. When these cells are fully loaded with oxygen, they are a bright red color. When the blood does not have enough oxygen, it is a dark bluish-red color and the overlying skin may appear slightly blue.

  • 4
    Chest retractions or nasal flaring
    male patient describing chest symptoms to doctor

    You know what healthy breathing looks like: the chest gently rises and falls with each breath. People who are experiencing respiratory distress have to work extra hard to breathe and you can often see their effort. You might notice what’s called chest retractions, or the muscles between the ribs sucking inward between breaths. Sometimes you can also see the muscles of the neck working as the person breathes. You might see nasal passages flare widely with each breath as well—that is nasal flaring.

  • 5
    doctor with stethoscope listening to elderly man's breathing

    The brain needs oxygen to function. When it doesn’t receive an ample supply of oxygen, the brain doesn’t work as well. In older adults and children, you might notice confusion. The person’s thinking might be slow and the individual may take longer than usual to respond to questions. Young children and infants may appear more tired or lethargic than usual. If someone is not behaving in their usual manner, seek medical attention, especially if they are also struggling to breathe.

  • 6
    Wheezing and grunting
    young woman with asthma attack or respiratory problem holding hands to chest

    Breathing is usually quiet. You may hear the quiet rush of air on inhalation or exhalation, but that’s about it. People who are experiencing respiratory distress may make unusual sounds for a variety of reasons. Wheezing (a high-pitched sound that usually occurs on inhalation) often occurs when the airways are narrowed, as during an asthma attack. Grunting that is heard on exhalation is an unconscious attempt to hold air (and oxygen) in the lungs.

  • 7
    Increased heart rate

    When the body isn’t pulling in enough oxygen, the heart speeds up in an attempt to pump the oxygen it has throughout the body. An increased heart rate on its own isn’t necessarily an indicator of respiratory distress. Heart problems, infection and other health disorders can also cause a faster-than-normal heart rate. However, a fast pulse coupled with shortness of breath is a definite sign of a problem. Call 911.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jul 10
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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