Indentifying Respiratory Distress in People With Asthma

Signs Include Shortness of Breath, Grunting, Nasal Flaring and More

Woman with breathing difficulties, France
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Respiratory distress is something that you want to avoid if at all possible. Thankfully, if you follow your doctor’s recommendations, most people can keep their asthma under good control. However, since poor asthma control may eventually lead to respiratory distress, it is best to be familiar with all of the signs.

You are already probably very familiar with all of the common symptoms of asthma, such as:

However, you may not be familiar with signs of respiratory distress. Signs of respiratory distress are things that you can see and observe as opposed to just purely feel about your asthma.

One of the most important skills you need to develop as a patient or parent of a child with asthma is to identify situations when you need to call your doctor or just head straight to the emergency department. All of the signs of respiratory distress indicate poor control of asthma. Make sure you review your asthma action plan with your doctor to determine what you can treat at home, when you need to call your doctor and when you need to head to the ER for emergency care.

Signs of Respiratory Distress

  • Breathing fast. The medical term for breathing fast is tachypnea. You can simply count the number of breaths in a minute to determine how many breaths you or your child is taking per minute. In an adult, anything over 20 breaths a minute is considered breathing fast. In children, the normal rates are based on age, so consult your pediatrician, family doctor or asthma specialist.
  • Changing color. Cyanosis or a bluish color that may be seen around the lips and mouth is a significant and worrisome sign of respiratory distress. Cyanosis indicates that the oxygen levels are very low and that you may soon need assistance breathing. In addition to cyanosis, the skin may look pale or gray as your oxygen levels lower.
  • Dyspnea. While this is the medical symptom for shortness of breath, there are a couple of signs that may allow you to know that someone is experiencing this. If your child is normally a good eater and cannot seem to get through a bottle without stopping every few seconds, your child may be experiencing respiratory distress. Similarly, if you or your child cannot carry on a normal conversation without having to take a break to catch a breath, this could be a sign of respiratory distress.
  • Grunting. When a child or adult experiences respiratory distress, he or she may grunt. Grunting occurs in respiratory distress by partially closing the vocal chords during expiration. By increasing the pressure in the lungs and slowing down expiration, grunting allows you to get more air into the lungs than from a normal breath.
  • Nasal flaring. If you are experiencing respiratory distress, your nostrils may open widely during inspiration in an attempt to get more air into the lungs. 
  • Retractions. Retractions are another important sign of respiratory distress. Some parents also refer to this as belly breathing because the belly pulls in as a baby breathes in. Retractions, however, refer to any pulling in of the skin associated with inspiration. They may occur in the neck or chest areas as well. You can watch this video of a baby having retractions.
  • Sweating. When breathing fast or working hard to breathe, you use extra energy. As a result, if you are experiencing respiratory distress you may sweat significantly. Rather than being flushed and warm as you might expect, you may see the color changes describe previously and the skin may feel cool to the touch.
  • Wheezing. Whistling noise heard when breathing when the airways are narrowed as a result of inflammation.

While all of these signs of respiratory distress may be seen in asthma, you may want to check out the symptom checker to see if they could be something else.

Avoid Respiratory Distress: Identify and Avoid Triggers

Avoiding respiratory distress altogether is the best move.

In order to do this you need to be a detective and determine what your triggers are and how you can avoid them. Check out the following articles that will help you identify and avoid your asthma triggers.

Take Your Medication to Prevent Respiratory Distress

Unfortunately many patients do not take their asthma medication appropriately. It is important to learn all you can about your asthma medication and how to work with your doctor to improve your asthma.

You and your asthma doctor need to get to know each other well. You need to feel comfortable enough to tell your doctor when you do not understand and when you have concerns. You can learn how to get more out of your visits. What do I need to bring? What questions will I be asked? What do I need to ask my physician? Your physician will have expectations from you as a patient and you will have certain expectations of your physician.


National Heart, Lung, and Blood Institute. Accessed: Aug. 13, 2011. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

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