What is the proper sequence for assessing a child who may have difficulty breathing?

The sequence of assessing a child who may have difficulty breathing is foundational for providing timely and effective care. Starting with visual assessment allows the caregiver to quickly gauge the child’s general appearance, respiratory effort, and any immediate signs of distress, such as retractions or cyanosis. This initial observation can reveal critical information, such as whether the child is in acute respiratory distress, what their positioning is (e.g., tripod position to maximize airflow), and overall comfort level.

Following the visual assessment with palpation can help in checking for any abnormalities, such as asymmetrical lung expansion or tenderness. Palpation can also provide insights into respiratory rate and depth. Lastly, auscultation is performed to identify any abnormal lung sounds, such as wheezing, crackles, or stridor, which can indicate specific airway or lung issues. This order—visual assessment first, then palpation, followed by auscultation—ensures that the assessment builds from a broad overview of the child’s condition to more specific details, allowing for a well-rounded clinical picture before deciding on the appropriate interventions.