Intercostal retractions

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Retractions of the chest muscles

This is an emergency, requiring immediate medical attention.

Seek immediate medical attention if intercostal retractions occur. This can be a sign of airway obstruction, which can quickly become life threatening.

Also seek medical care if the skin, lips, or nailbeds turn blue, or if the person becomes confused, drowsy, or is hard to wake up.

In emergency situations, the health care team will first take steps to help the patient breathe. This may include oxygen, medicines to reduce swelling, and other treatments.

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When the person is stable, the health care provider will perform a physical exam to determine the cause of the airway obstruction. Questions will be asked about the symptoms and the person's medical history, including:

• When did the problem start?
• Is it getting better, worse, or staying the same?
• Does it occur all the time?
• Did you notice anything significant that might have caused an airway obstruction?
• Have you or the child been ill, coughing, or complaining of a sore throat?
• Has the child put anything in the mouth that might have been inhaled into the airway?
• What other symptoms are present? For example, did the child turn blue, wheeze, or have a high-pitched sound when breathing (stridor)?

Diagnostic tests may include:

• Arterial blood gases
• Chest x-ray
• Complete blood count (CBC)
• Pulse oximetry to measure blood oxygen level

Review Date: 04/26/2010
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).