Immediate Questions

A. Does patient have impending respiratory failure or a life-threatening condition that requires immediate attention (eg, tension pneumothorax)? Respiratory failure leads to respiratory arrest if early recognition and intervention are lacking. Prognosis is poor in children who undergo respiratory arrest.

B. Is patient apneic, hypoxic, or hypoventilating? Differential diagnosis and management are shaped by this distinction.

C. What clinical features are associated with respiratory distress in this patient? Fever suggests an infectious etiology. Symptoms of upper respiratory infection are consistent with viral cause. Anaphylaxis is a consideration if distress is temporally associated with a particular food or medicine.

D. Has patient or a family member had a similar episode? This type of pattern can be seen with asthma.

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