Pediatric Respiratory Assessment Part 5

Lung and Airways Sounds

·         Stridor

·         Wheezing

·         Grunting

·         Gurgling

·         Crackles

Stridor

·         High-pitched sound during inspiration

·         Indicates upper airway obstruction

·         Causes include congenital and acquired abnormalities:  infection, allergic reactions, tumors, aspiration of a foreign body

Wheezing

·         Suggestive of intrathoracic airway obstruction and narrowed intrathoracic airways

·         Usually accompanied by prolonged expiration

·         Causes include asthma, pulmonary edema, foreign bodies

·         Diminished breath sounds

·         Suggestive of airflow obstruction, lung parenchymal disease, or poor respiratory effort

Grunting

·         May be caused by partially closed glottis

·         Occurs during expiratory phase

·         Indicative of small airway or alveolar collapse

·         Occurs in patients with loss of lung volume associated with pulmonary edema, pneumonia, or atelectasis

Gurgling

·         Bubbling sounds heard during either phase of respiration

·         Results from secretions, emesis, or blood in the upper airway

Crackles

Sharp, crisp, crackling sounds heard during inspiration

May be described as moist or dry

Moist crackles may be associated with accumulation of alveolar fluids

Dry crackles may be heard with atelectasis and interstitial lungs disease

Note:  Suggestive of airflow obstruction, lung parenchymal disease, or poor respiratory effort

Source:

Pediatric Advanced Life Support Provider Manual by Leon, M.D. Chameides, Ricardo A., M.D. Samson, Stephen M., M.D. Schexnayder and Mary Fran, RN Hazinski (Oct 12, 2011)