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Introduction

Infants get common cold or respiratory tract illness when season changes or in the fall or winter.The baby may appeared tired, decreased in activity, decreased in appetite, got noisy breathing sound, even tachypnea, cyanosis or chest retraction.

How to deal with the baby with respiratory distress when having cold, bronchiolitis, or asthma?

1. Observe the respiration pattern of the baby:

• Has the breathing rate increased?

the normal range should be within 40-60 per minute, differed by age

• Has the respiration pattern changed?

chest breathing is abnormal.

• Has the respiration taken effort or is it shallow?
• Is there abnormal breathing sound?
• Is there coughing or sputum?

2. Is the peri-oral area pale or blue?
3. Is the baby irritable, decreased in appetite, or decreased in activity?
4. Put the baby in the air circulated room and increase the humidity.
5. Take more water or use the mucolytic agents with doctor’s order to dilute the sputum.
6. Perform chest physical therapy and postural drainage between meals to facilitate the excretion of sputum.
7. Once the baby has the air way disease, his(or her) lung is just like a balloon filled with some liquid(sputum).That means, the inhaled and exhaled air is not as much as before; therefore, the efficacy of gas exchange in the lung decreased.

Chest physical therapy and postural drainage are helpful in the excretion of the sputum and improving respiratory function.

Usually a baby doesn’t know how to expectorate, but the postural drainage will help it to drainage the sputum to the mouth and pharynx, then the baby would swallow it and remove it from the body by defecation or from the nose.

How to detect where sputum is?

• Please put your ear closely near the baby’s chest wall to listen to the baby’s breathing sound, the sputum is at where noisy breathing sound was heard.

What are postural drainage and percussion ?

Postural drainage, relies on gravity and change of body posture to excrete the sputum accumulated in the lung from the tracheal or esophagus.

Usually performed 1 hour before feeding to avoid vomiting. Each course would take 10 -15 minutes.

Percussion: Cupping your palm or use the percussion-device and strike the chest wall repeatedly.

Position: have the side with sputum facing up-right ( if there is sputum in the left chest, have your child lie on his or her right, and then tap on his or her left chest). If there is sputum in the right chest, vise versa. This will be helpful in loosening sticky sputum and facilitating the postural drainage.

This should be non-tenderness if it’s performed correctly. Use the pillow as the cushion on the chest wall; use the wrist to tap the chest wall with stable physical strength for 3 -5 minutes anteriorly and posteriorly.

* Caution: Do not perform percussion on the bone, spine and rim of ribs !

Common position used in postural drainage

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