Question: How would you assess the work of breathing?

Answer: Look, listen and feel:

• Mechanics:
  • Rate, recession, tracheal tug/ deviation, accessory muscles, body position, grunting, equal air entry?
  • Added sounds? (e.g. wheeze)
  • Silent chest = no air entry
  • Equal chest expansion?
• Effort:
  • Heart rate, skin colour, drowsiness, agitation
• Effectiveness:
  • Level of consciousness
  • Oxygen saturation

Lower chest indrawing is a key sign.

ETAT+ danger signs are cyanosis/SpO2<90%, reduced level of consciousness, grunting and inability to drink.