Understanding and managing breathing problems in children

Paediatrics’ patient group is a group that needs knowledge and skill when it comes to patient assessment. According to research, paramedics often lack routine in this patient group due to minimal EMS missions involving children compared to adults (Oulasvirta et al. 2021). This gives healthcare workers insecurities when it comes to treating children and for this reason, we picked this topic for the thesis – to gain knowledge, as we will encounter this patient group as upcoming healthcare workers.

Breathing difficulties are one of the most common reasons for pediatric EMS missions, especially during nighttime hours. The underlying causes of these difficulties are diverse and include viral and bacterial infections, as well as environmental triggers. The unique physiology of children – such as narrower airways and an under-developed immune system – makes them particularly vulnerable to respiratory conditions (Oulasvirta et al. 2021.)

Children experiencing respiratory difficulty may present with symptoms such as rapid breathing, nasal flaring, wheezing, grunting, use of accessory muscles, or cyanosis. Understanding the common causes and available treatments is key to immediate and effective care (Oulasvirta et al. 2021.)

Early signs and common causes of respiratory difficulties

Respiratory difficulty is often treated as a condition, but it can more accurately be approached as a symptom – an indicator of underlying issues. Infections such as laryngitis and influenza remain common causes. These infections lead to airway inflammation, mucus buildup, and impaired gas exchange, making breathing difficult for the child. However, a proactive approach enables earlier recognition and intervention, preventing complications before they worsen. (Amadi et al. 2025.)

Asthma is one of the most prevalent chronic respiratory conditions in children. Triggers such as pollen, dust, or physical exercise can lead to sudden bronchospasm, causing wheezing, shortness of breath, and chest tightness. Early symptoms often go unnoticed until they develop into more severe exacerbations, highlighting the need for close monitoring and timely treatment. In predisposed children, even minimal exposure can cause sudden and severe symptoms. (Amadi et al. 2025.)

Foreign body ingestion, particularly among toddlers, is another crucial cause that should not be overlooked. Ingested objects like small toys or food particles can cause complete or partial airway blockage. Environmental factors play an equally important role in paediatric respiratory health. Acute exposure to allergens such as nuts, insect stings, or medications can result in anaphylaxis, a life-threatening allergic reaction that leads to airway swelling and breathing difficulty. (Amadi et al. 2025.)

Understanding the impact of acute respiratory difficulty and its  treatment in paediatric wellbeing

Acute respiratory difficulty in children can be distressing not only physically but also emotionally, affecting not only the child but also their parents. Beyond clinical diagnosis and treatment, these episodes often disrupt daily routines, sleep, school performance, and social interactions. The psychological toll on families can be significant, especially when recurrent episodes occur without clear patterns or warning.

Treatment for acute paediatric respiratory difficulties depends on the underlying cause and severity of the symptoms. Common interventions include bronchodilators and corticosteroids for asthma, inhaled racemic adrenaline for laryngitis, and intramuscular epinephrine for anaphylaxis. Oxygen therapy, patient positioning, and calm environment support are also important. Foreign body obstructions may require emergency removal. Prompt ans appropriate intervention can significantly improve outcomes. (Amadi et al. 2025; Lyng et al. 2022; Martin et al. 2022; White et al. 2023.)

References

Amadi, C., Salo, D. & Äijö, S. 2025. Common Causes and Treatments of Acute Respiratory Difficulties in Children. Thesis. LAB University of Applied Sciences. Cited 24 Apr 2025. Available at https://urn.fi/URN:NBN:fi:amk-202504247519

Lyng, J., Harris, M., Mandt, M., Moore, B., Gross, T., Gausche-Hill, M., & Donofrio-Odmann, J. J. 2022. Prehospital Pediatric Respiratory Distress and Airway Management Training and Education: An NAEMSP Position Statement and Resource Document. Prehospital Emergency Care. Vol. 26(1), 102–110. Cited 22 March 2025. Available at https://doi.org/10.1080/10903127.2021.1992551

Martin J, Townshend J, Brodlie M. 2022. Diagnosis and management of asthma in children. BMJ Paediatrics Open. Vol. 6(1): e001277. Cited 17 March 2025. Available at https://doi.org/10.1136/bmjpo-2021-001277

Oulasvirta, J., Harve-Rytsälä, H., Lääperi, M., Kuisma, M. & Salmi, H. 2021.  Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine. Vol. 29 (13). Cited 12 March 2025. Available at  https://doi.org/10.1186/s13049-020-00816-8

White, J., Cambron, J., Gottlieb, M. & Long, B. 2022. Evaluation and Management of Airway Foreign Bodies in the Emergency Department Setting. Vol. 64 (2), 145 –155. Cited 2 March 2025. Available at https://doi.org/10.1016/j.jemermed.2022.12.008

Tozer, M. 2024. EMS Medication Administration – Inhalation Route. Cited 22 Apr 2025. Available at https://www.embrace-the-elements.com/2024/06/ems-medication-administration_24.html?m=1