Toddler's Sudden Breathing Trouble: Should We Go to the ER?
A 22-month-old boy, who is generally healthy and not on any regular medications, resides in a rural area of British Columbia, Canada. Earlier this year, in February 2025, he was given a prescription for salbutamol after experiencing a severe respiratory infection that led to pneumonia; however, he was deemed fit to discontinue its use by April 2025. His family has a history of serious asthma and chronic obstructive pulmonary disease (COPD). He went to sleep at 8:00 PM without any issues—no coughing, wheezing, sneezing, or breathing difficulties at that time. His energy levels were normal, and he had a regular appetite, along with typical bathroom habits. At midnight, he awoke crying. When I arrived in his room, he was coughing and appeared to be gasping for air, with breathing that resembled the sounds of someone in distress. He usually sleeps with a pacifier and a blanket; however, the blanket had been kicked off during the night. The last time I checked the monitor at around 10:00 PM, he was on his back, and the blanket was to the side. He quickly settled down and fell back asleep, yet his breathing remained wheezy and raspy, accompanied by occasional coughs. After watching him for a while, he woke up again, displaying increased signs of discomfort. I attempted to administer salbutamol, but he resisted, making it difficult to gauge how much medication he inhaled. He requested milk, and fortunately, he was able to keep it down. I decided to stay awake with him and monitor his condition. Since then, his breathing has improved significantly; although he still has the occasional cough, the wheezing has decreased, and he seems to have returned to his normal self. Considering the circumstances, should I continue monitoring his condition and call his doctor in the morning, or is it necessary to take him to the emergency room? Given the rural location with no urgent care available, my options are limited to waiting for a doctor's appointment or heading to the ER. Thank you for your advice.
Answers (1)
6/11/2025, 8:01:50 AM
OpenHealth AI
It's understandable to be concerned about your toddler's sudden breathing difficulties, particularly given his medical history and family background. While his condition seems to have improved at this moment, assessing the need for immediate care is essential.
Key Points:
- Your toddler's breathing troubles, particularly with a background of respiratory issues, warrant close monitoring.
- His improvement is encouraging, but persistent symptoms such as wheezing and coughing can indicate underlying issues.
Explanation:
The sudden onset of coughing and gasping for air, especially during sleep, can be indicative of conditions such as asthma exacerbation, allergies, or respiratory infections. Given his previous respiratory issues and family history of asthma/COPD, it's crucial to stay vigilant. The fact that his breathing has improved significantly is a positive sign, but it doesn't completely eliminate the need for caution.
Next Steps:
-
Continue Monitoring: Keep a close watch on his breathing. Look for any signs of distress, such as:
- Rapid or labored breathing
- Stridor (a high-pitched wheeze during inhalation)
- Skin pulling around the ribs or neck (sign of difficulty breathing)
- Changes in his color (pale or blue-tinged)
-
Keep the Environment Calm: Ensure he stays calm and comfortable. Avoid any irritants like smoke or strong fragrances.
-
Salbutamol Administration: Try to administer the salbutamol again, if possible. Use a spacer if you have one, as it can help the medication to reach his lungs more effectively. You may want to gently encourage him, perhaps by demonstrating the inhalation yourself or using an exciting story to distract him.
-
Hydration: Keep him hydrated. Sips of water or milk can help soothe the throat if he’s coughing.
-
Call His Doctor: Reach out to your doctor in the morning to discuss what happened overnight, especially your concerns and his past respiratory history.
When to Seek Emergency Care:
If at any point his breathing worsens, or if symptoms like fever, persistent coughing, or exhaustion occur, or if he shows signs of distress that don’t improve, consider going to the emergency room.
Being proactive about his health is important, and keeping a watch on his symptoms now is the right course of action. Let me know if you need any more information or support!
Related Questions
16-Year-Old Dealing with Scoliosis and Breathing Issues: Seeking Advice
As a 16-year-old male, I’m currently coping with gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS), while also having been diagnosed with an S-shaped type of scoliosis. During my latest spinal evaluation in 2023, the findings revealed: - Thoracic curve: 25°, bending towards the right - Lumbar curve: 45°, bending towards the left For many years—long before my scoliosis diagnosis—I have been experiencing sporadic shortness of breath, approximately once a month or even less frequently. In June, I visited a clinic because I was suffering from a persistent cough following a viral infection. The attending physician conducted an X-ray and subsequently referred me to the emergency room after she suspected I might have a pleural effusion. Upon arriving at the ER, a CT scan was performed, revealing that the curvature of my spine was exerting pressure on my left lung. Initially, my oxygen saturation level was recorded at 88%. However, due to my shaky hands, the physician questioned the accuracy of this reading. Upon retaking the measurement, my oxygen saturation stabilized between 94% and 99%, and arterial blood gases indicated normal levels. Later on, I consulted a senior pulmonologist who recommended that I prioritize appointments with spine specialists rather than pulmonary care providers, and proceeded to order a spirometry assessment. I chose to delay this test due to frequent panic attacks, fearing these might negatively impact the results. However, I am now set to undergo the spirometry test in three weeks and would like to know if anyone else has experienced a comparable situation. I’m also feeling anxious about the potential for pulmonary hypertension. To provide further context, in April, I underwent two echocardiograms: - The first one, carried out by a junior doctor, indicated an estimated pulmonary artery pressure (EPASP) of 48 mmHg. - The second one, just two days later, was performed by a more experienced cardiologist and showed an EPASP of 30 mmHg alongside a tricuspid regurgitant velocity (TRV) of 2.64 m/s. Additionally, I have concerns about possibly having a pectus deformity, or conditions like Swyer-James-MacLeod syndrome, even though these have not been formally diagnosed. Given all of this, how concerning do my lung conditions appear? Can scoliosis by itself account for these symptoms? Moreover, does this situation escalate potential concerns regarding pectus deformity or Swyer-James-MacLeod syndrome?
Breathing Difficulties
Hello everyone. I’m a 25-year-old male, standing at 1.80 meters and weighing 110 kilograms. I take 75 mg of Sertraline daily and have never been a smoker. Recently, I’ve experienced some unusual symptoms and seek your advice. Approximately a week and a half ago, I noticed what felt like a weakness or fatigue on the right side of my face. I didn’t think much of it at first. However, the following day, I began to sense a change in my breathing. Although I could still manage to take deeper breaths, I felt a peculiar pressure in my chest, particularly after eating. This made me more mindful of my breathing patterns. While this pressure subsided somewhat on its own, this morning I experienced something concerning. After using the restroom, I instinctively tried to take a deep breath, but my body seemed to cancel it, only allowing a small intake of air. When I forced myself to take a deeper breath, I was able to, but the volume of air I could inhale felt reduced compared to before. The difference is slight but noticeable. Additionally, after attempting several deep breaths in quick succession, I've developed a persistent urge to breathe deeply every few seconds, and this sensation has not abated for the last 20 to 30 minutes.
Concerns About My Brother's Nighttime Breathing Issues
My 26-year-old brother has been struggling with a cold for the last three weeks, but recently, he's been experiencing alarming episodes while sleeping. For the past week, he has repeatedly awoken during the night, gasping for breath for periods of about three to five minutes, as if his throat is nearly shut, leaving him on the brink of fainting. I've been sleeping in the adjacent room and each time it happens, it sends me into a panic. Just a little while ago, he woke up intensely gasping for air, taking an exhausting three minutes to recover his breathing. He seems to be trying to clear his throat of something stuck, but with no success. He has visited urgent care four times, and an x-ray of his lungs revealed no signs of pneumonia. While we suspect he may be dealing with a respiratory infection, the doctors have not confirmed this diagnosis. They have, however, provided him with an inhaler and prescribed medication to alleviate his cold symptoms. To give you some context, my brother is 6 feet tall and weighs 155 pounds, a drop from 165 just last week. He is of Caucasian descent, does not smoke cigarettes, is generally healthy and athletic, and only uses marijuana occasionally. He is not on any long-term medications, but he has received a prescription for his cold, which he has almost recovered from. Have any of you encountered similar symptoms before?
Unusual Bruising Following Fibula Fracture?
I am a 28-year-old woman, standing 5 feet 6 inches tall and weighing 126 pounds. I live in Madison, Wisconsin, and have been dealing with some health issues. My medical history includes asthma, anxiety, gastroesophageal reflux disease (GERD), chronic migraines, endometriosis, insomnia, and ADHD. Currently, I am on several medications, including gabapentin, topiramate, buspirone, Estraylla (birth control), prazosin, and folic acid. I broke my fibula about four days ago, and I am feeling quite anxious about my recovery. The bruising around the injury site has increased significantly, even after accounting for the potential bruising and blood clot risks associated with wearing a boot. I have diligently followed the treatment plan given to me by my orthopedic specialist, which includes the use of Bayer. However, I have never experienced bruising like this, particularly the unusual shapes that have developed. Should I be worried about this? I truly value the wisdom and support of this community, and any guidance or feedback would be greatly appreciated. Thank you in advance for your help!
Understanding My Inhaler Needs
I'm a 21-year-old woman weighing 180 pounds and I've been trying to get in better shape, although I'm not quite there yet. I run whenever I have the opportunity, and I don't smoke. Living with autism, generalized anxiety disorder (GAD), and depression, I manage my conditions with Strattera and Prozac. I suspect that I may have asthma, although I'm currently unable to access my medical records for confirmation. Recently, I received my first inhaler, which contains Albuterol Sulfate. My mom has been insisting that I get one for a while, as asthma is common in our family. In the past, I've had to rely on my brother’s and father's inhalers during emergencies. However, my autism makes me quite particular, and I tend to downplay my own symptoms. This has led to confusion regarding when I should actually use my inhaler. I understand that it's meant for instances when I experience breathing difficulties, but I'm unclear whether coughing so severely that it hinders my ability to take a full breath qualifies for inhaler use. Furthermore, if I feel out of breath after exercising or climbing stairs, should I consider that a trigger as well? Are there specific indicators or numbers I should monitor to determine when it's appropriate to use my inhaler or to recognize concerning symptoms?