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Abnormal Breath Sounds

Warning Signs of Breathing Difficulty

Noisy Breathing

 

     Normal breathing is quiet. When you can hear noisy breathing, it usually means something is in the airway, making it difficult for air to get through.  Most of the time, the “something” is congestion that has developed due to an infection, but it can also be swelling, fluid, tissue, or something swallowed (aspirated). The noise is coming from the air pushing around or through the obstruction.  The different types of obstacles make different sounds  (see video links for examples under Normal Breath Sounds above)

 

Mucous

If mucous is causing the problem, the solution is to try to get it out of there. Our body’s natural way of doing that is by coughing. If coughing is not bringing up anything is called a non-productive cough.  If it’s bringing up phlegm or mucous, it’s called a productive cough.

 

Mucous is usually clear and thin or some form of white. The thicker and darker it appears, the more likely that something is going on inside. However, that depends on the individual’s history.  Some chronic respiratory patients keep an underlying mucous thing going all the time, and they have yellow phlegm rolling out all year. It’s their normal—nothing to cause excitement.

 

Infection

However, if their normal suddenly turned green or black or bright red, then that’s another story.  Those colors are never good for anybody.  The darker the sputum in color, the worse the infection.   Additional signs of infection include fever, confusion, difficulty breathing, shortness of breath, or more noise with breathing.

 

Cyanosis

If the lungs fill with congestion to the point that oxygen can’t get out to the rest of the body, a crisis develops.  Often, you see cyanosis (blue-tinged coloring) in mucous membranes around the lips and fingernail beds. There is a sort of pallor that accompanies the blue tint of the skin. The person looks almost grey. They need oxygen immediately. If you have a pulse-ox that can read oxygen saturation, check to see how low the oxygen has dropped.  If you have oxygen at home, apply it immediately. If you don’t have oxygen, call 9-1-1.

 

Referenced: Beare, Patricia G., and Judith L. Myers. Principles and Practice of Adult Health Nursing. (1990) St. Louis: C. V. Mosby Company. 553.

Call Your Doctor If You Have Any of the Following Symptoms

  • You are getting a lot of headaches.
  • You feel more nervous or irritable than usual
  • Your lips, gums, area around the eyes, or fingernails are a dusky, gray, or bluish color
  • You feel drowsy or confused; children are very limp or weak
  • Your breathing is slow, shallow, difficult, or irregular. You feel like you are short of breath.
  • For Children: Breathing faster than usual, flaring nostrils when breathing, making a grunting noise, the chest is pulling in with each breath, not eating well, trouble sleeping, plus any of the above.

Reference: https://medlineplus.gov/ency/patientinstructions/000048.htm

The Breath of Life

     Have you ever taken a CPR course? If so, you probably heard about the ABC’s of Life.  The ABC’s are a reminder of what must be treated first to keep the body alive in an emergency.

 

  • A = Airway – check to see if anything is getting in the way of the flow of air into or out of the lungs
  • B = Breathing – Is the act of breathing occurring as often, as deeply, and as effectively as it needs to happen to sustain life?
  • C = Circulation of oxygen – Is oxygen exchanging places with carbon dioxide in the blood?

 

     When someone has a medical diagnosis involving the respiratory system, most of the time, something is not right with one of the functions listed above:

  • either the way they breath is not effective,
  • their airway is obstructed due to not being able to keep their airway clear, or
  • there is something wrong with how oxygen/carbon dioxide gets exchanged. 

Abnormal Breath Sounds

What to Tell the Doctor

     You realize something is wrong, and you’re about to pick up the phone to call your doctor.  What information will he/she want to know from you so that he/she can make the most informed decision about the situation?  You need to be his/her eyes and ears.   Here are the details you need to know when you call based on the symptom.

 

Coughing: 
  • How long has the cough been present?
  • Does it happen at a particular time of day or all-day?
  • Is it productive (producing sputum) or dry (nothing coming up)?
  • What does it sound like?
  • How often is it occurring?
  • Does anything help relieve it?

 

Sputum Production:
  • Is it coming up just with coughing or must it be induced? 
  • What are the color, consistency, and odor?” 
  • How much is coming up each time?
  • What is the consistency (thick, watery, frothy, 

 

Blood Tinged Sputum
  • Rust-colored sputum -describe how much and how often.

 

     Here are also a couple of videos on how to assess the lungs that you may find helpful or interesting.

 

Lung Auscultation Landmarks, Sounds, Placement, Assessing Lungs

     https://www.youtube.com/watch?time_continue=112&v=KNrcG077brQ

 

Lung Assessment Lung Auscultation Part 2

 

     https://www.youtube.com/watch?time_continue=2&v=xdSmc0010To

 

how do you describe breath sounds?

A pleural friction rub is caused by inflammation of the lining of the lungs rubbing together. It is heard both during breathing in and out and sounds like a low-pitch harsh/grating noise. Tell the doctor you hear it when the person breaths in and out and it sounds like scraping or grinding.

Coarse crackles (rales) are low-pitched wet, bubbling sounds heard mainly when inhaling,  but can extend into exhaling.

Fine crackles are high-pitched crackling sounds heard mainly when inhaling. 

Stridor, a type of wheezing, is heard on inspiration and is a high-pitched whistling or gasping sound with a harsh sound quality. It may be seen in children with conditions such as croup or epiglottitis, or anyone with an airway obstruction. It requires medical treatment.

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