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Assessment of a Child's Respiratory System

Signs of increased work of breathing (WOB):

  • Difficulty speaking/feeding

  • Expiratory grunting

  • Recession – Tracheal tug, Supraclavicular, Intercostal, Subcostal

  • Accessory muscles – Nasal flaring, Head bobbing


N.B. Always assess a child's chest properly as you can tell a lot about their condition just by inspection.

“Intercostal retractions in a newborn with breathing difficulties” © Bobjgalindo CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/)

Normal ranges:



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