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Respiratory distress is a life threatening symptom characterized by the inability to breathe comfortably. In a normal human being, breathing is an automatic process done without any conscious effort on the part of the individual and continues during sleep and periods of unconsciousness. It is usually characterized by:
- Hyperpnea - deeper than normal breathing
- Tachypnea - faster than normal breathing
- Conscious use of auxiliary breathing muscles, such as those in the chest, rather than just the diaphragm
- Depression of the skin around the ribs and the top of the sternum
Respiratory distress goes beyond mere difficulties breathing, such as might be experienced by a patient suffering from a common cold or allergies. In those cases, the upper respiratory tract (the nose) may be congested but the lower respiratory tract is generally clear and, once a sufferer is asleep, breathing still continues normally. By contrast, respiratory distress is characterized by difficulty breathing even when extremely fatigued and on the edge of sleep, wheezing, continuous coughing, and gasping.
When a patient is suffering from respiratory distress, treatment is usually focussed on the immediate cause, such as fluid in the lungs or airways, bronchial constriction, swelling of the airways, and so on. Treatment can range from adrenaline (epinephrine) to open up the bronchial passages to a tracheotomy to bypass the upper airways altogether.
Unfortunately, respiratory distress is not very much use in a differential diagnosis as there can be numerous causes for each of the issues that will give rise to respiratory difficulties. However, the differential usually starts with problems in the heart, then in the lungs and respiratory system, then finally to other causes, the most common of which is diabetic ketoacidosis.