Respiratory distress in infants and children, if not properly identified and treated, can result in cardiac arrest and permanent brain injury. The failure to diagnose and treat respiratory distress in children may be a form of medical malpractice.
It is critical for medical professionals to recognize the signs and symptoms of respiratory distress in children, which include gasping, wheezing or inability to make any sound at all. If the signs of respiratory distress appear severe, and the child exhibits cyanosis (blue color to the skin) or pallor; or if the infant has a heart rate less than 60 beats per minute, CPR should be instituted.
A high level of suspicion is mandatory when dealing with any respiratory distress in a child. Failure to deliver oxygen to the cells of the heart can cause cardiac arrest, and failure to deliver vital oxygen to the brain will inevitably result in permanent brain damage.
A child in respiratory distress should be observed for some time in an emergency department, and possibly admitted to the hospital for further evaluation. Often, respiratory distress is caused by infection, particularly respiratory syncytial virus. The patient is usually treated with inhalers that relax the airways in the case of reactive airway diseases, which constrict the airways and prevent the passage of oxygen.
Another consideration is asthma, which may be difficult to diagnose in infants. Failure to treat an asthmatic attack in a child can result in increasing severity of the cycle of inflammation, and can easily result in death or brain damage from hypoxemia. Appropriate treatment might include, in addition to nebulized medications that relax the muscles surrounding the airway, steroids to decrease the inflammation.
Another situation in which the child’s airway may be compromised is an infection known as epiglottitis. Although this is less common than it was a few years ago, epiglottiis creates swelling of the epiglottis, at the posterior portion of the pharynx, and the airway can quickly close up, requiring a surgical airway. A peritonsillar abscess can also compromise the airway, and should be drained when diagnosed.
Severe respiratory distress is an immediate indication to provide a secure airway, which usually means insertion of an endotracheal tube through trachea, and then connecting that tube to a bag-valve mask and eventually to a mechanical ventilator. Failure to obtain an airway in the case of respiratory distress is negligent. There are various options for obtaining an adequate airway, if endotracheal intubation is difficult.
Recognition of respiratory distress in children is critical – children who are not given appropriate attention and provided appropriate medical care can develop permanent brain damage. Infant patients with clear signs of respiratory distress, such as gasping or difficulty breathing, who or only briefly examined and sent home from the hospital with virtually no treatment (such as merely being given an inhaler) can suffer disastrous and permanent injury or death.
If you have ever taken your child for care of respiratory compromise, and it has not been appropriately treated, your child may have suffered permanent brain damage or death. These tragedies can sometimes be preventable. You may consider consulting a medical malpractice attorney to assess your case, as damages may accrue over a lifetime of medical care and disability.
For a Free Consultation with one of Passen & Powell’s top-rated medical malpractice attorneys, call us at 312-527-4500.