Fever with or without general malaise: (≥ 38⁰C rectal or ≥ 37.5⁰C oral/armpit)
Possible cause(s)
- Respiratory infection
- Other infection
What to do?
- Contact your healthcare team quickly.
General irritability, poor appetite, fatigue or wanting to sleep more than usual (lethargy)
Possible cause(s)
- Change in baseline health of the child may indicate new infection or other problem
What to do?
- Note any other changes or symptoms that your child may have.
- Contact your healthcare team quickly.
One or more of these symptoms of breathing difficulties: shortness of breath, trouble breathing or noisy breathing; breathing more quickly; chest pain; coughing more than usual or has a weaker cough; faster heart rate than usual; chest retractions and/or nasal flaring; decreased oxygen saturation compared to their normal values; purple or gray lips, tongue or fingertips (cyanosis); clammy skin\cold extremities; changes to behavior either fatigue or irritability; more comfortable breathing when sitting up; extends their neck and head backwards to take in a breath
Possible cause(s)
- Equipment malfunction
- Respiratory tract infection (eg, tracheitis, pneumonia
- Mucous plug
- Other health problems
What to do?
- If your child is in SEVERE respiratory distress:
- If your child is in MILD respiratory distress:
- Try suctioning the secretions.
- If your child has medications that have been previously prescribed for these symptoms (eg, Ventolin), administer them as prescribed or according to your child’s healthcare team.
- Contact your child’s healthcare team immediately.
One or more of these symptoms: decreased urination, increased thirst, dry lips and mouth, faster heart rate than usual, weight loss
Possible cause(s)
What to do?
- Contact your healthcare team quickly.
- Give oral rehydration solutions to your child (eg Pedialyte™, Gastrolyte™), if recommended by your healthcare team.
Dizziness or fatigue
Possible cause(s)
- Less than 10 minutes between each session
- Session is too long
What to do?
- Let your child rest.
- Wait 10 minutes between each session.
If the dizziness is severe:
- Stop the technique immediately.
- If the symptoms reappear again, contact the healthcare team.
Bloating of the abdomen with burping after lung volume recruitment technique or insufflation/exsufflation technique
Possible cause(s)
- Air is entering the stomach instead of the lungs
What to do?
- Remind your child to relax during the insufflations of air; he must not resist air entry.
If the discomfort persists:
- Stop the technique immediately.
- Quickly contact the healthcare team.
Stomach upset during lung volume recruitment technique or insufflation/exsufflation technique
Possible cause(s)
- The technique was applied during or immediately following a meal
What to do?
- Stop the technique immediately unless your child is really congested with secretions.
- Avoid applying the technique within 2 hours before or after a meal.
- If needed, suction the secretions.
Chest/abdominal discomfort or pain during lung volume recruitment (breath stacking) or insufflation/exsufflation technique
Possible cause(s)
- Sore chest or abdominal muscles
- Too much air in the lungs
What to do?
- It is normal that your child feels a slight pulling of the chest muscles when the therapy is first started. This discomfort will gradually disappear.
If he feels pain:
- Stop the technique immediately.
- Contact the healthcare team as soon as possible.
Inability to expectorate (clear) the secretions
Possible cause(s)
- Poor technique
- Thicker secretions
- More secretions than usual
What to do?
- Review the technique.
- Combine more than one technique at a time (eg, pulmonary hyperinflation with abdominal thrusts) in order to increase the efficacy of secretion clearance.
- Make sure that the humidity level is adequate.
- If the problem persists, contact the healthcare team quickly.
Abdomen does not move outwardly during lung volume recruitment technique or insufflation/exsufflation technique
Possible cause(s)
- Poor technique
- Lack of collaboration by your child
What to do?
- Review the technique.
- Make sure that there is no leak (mouthpiece, facial mask, tubing).
- Make sure that your child is relaxed.
- If the problem persists, contact the healthcare team.
Abdomen does not move outwardly during lung volume recruitment technique or insufflation/exsufflation technique
Possible cause(s)
- Poor seal around the mouthpiece
What to do?
- Make sure that your child closes his mouth firmly around the mouthpiece.
- Make sure that the mouthpiece is properly inserted in the modified ventilatory bag.
- If needed, use a facial mask.
- If the problem persists, contact the healthcare team.
Leak from the nose during lung volume recruitment technique or insufflation/exsufflation technique
Possible cause(s)
- The air is leaking through the nose rather than going to the lungs
What to do?
- Use a nose clip.
- If the problem persists, use a facial mask.
- If the problem continues to persist, contact the healthcare team.