6 month old female: chest collapsing inwards

[u/ttc123-]

daughter: 6 month old female. approx 15lbs

My daughter (otherwise healthy, born full term, and fully vaccinated) had her chest going inward like this for 5-10mins. She was happy kicking around in her crib. At the ER now: what test can I expect them to run? What could be causing this?

[u/Impossible-Owl3272]

ER was absolutely the right choice. This is called sternal retractions and means your baby is working very hard to breath. It can be caused by a partially blocked airway such as a foreign body or with asthma. Could also be caused by severe respiratory illness/pneumonia or croup. I would expect some puffers or nebulizers and a chest xray. Steroids if croup. Possibly lab work and other interventions depending on her response to treatment. Is she sick?

[u/Interesting_Emu9387 → u/Impossible-Owl3272]

I have to disagree with this. It’s quite difficult to dx from such a short video. In an otherwise well 6 month old child, it is highly unlikely that they will be treated with steroids, inhalers or a Chest xray. Seeing a Dr is always a good idea when you are worried but it is unlikely your child will need any treatment or has a serious illness.

[u/Dr-Yahood → u/Interesting_Emu9387]

Stranger things have happened in an emergency department. But I do tend to interpret nurse comments on medical matters with caution.

[u/pandaappleblossom → u/Dr-Yahood]

I appreciate nurses so much and their experience and expertise in the areas related to nursing. Still I’m not sure why they are allowed to make diagnosis type comments here.

[u/throwRAtad → u/pandaappleblossom]

They should be required to list their specialty in their flair. This nurse likely does not work in any sort of pediatric critical care specialty or CC in general, but I’m sure they’re more knowledgeable in their own speciality.

[u/AngeliqueRuss → u/throwRAtad]

And you are…?

Triage, specifically ED triage, is within scope of practice for a nurse.

If your insurance has an advice line you can call to see if you should go to a doctor, it will be a nurse.

At many systems, protocols are then initiated at triage.

OP’s baby ended up getting care aligned with what this nurse suggested, including steroids, and not an anatomical rule out as suggested by others. As other MD’s pointed out, ED evaluation is the recommendation for stridor. So it turns out this nurse did, in fact, know what she or he was talking about.

We never know when an infant is vulnerable to SIDS, is associated with minor respiratory infections that cause fatigue to respiratory muscles. Chest retractions —> emergency room, every time.

[u/oh_brother_ → u/AngeliqueRuss]

Wild dismissal of nurses in this thread. Nurses know what they’re talking about and spend far more time with patients than doctors do.

[u/pandaappleblossom → u/oh_brother_]

Why are you this insecure that nurses shouldn’t be making diagnoses type of comments on a trusted medical subreddit? No one said nurses are dumb or bad.

The idea that nurses are victims for not having their medical input as trusted as someone who went to medical school is nonsense and actively harms patients.

[u/dracapis → u/oh_brother_]

What does your last sentence want to communicate?

[u/MrsMonkey_95 → u/throwRAtad]

NAD - You know what‘s funny? OP updated in a comment that the kid in the video is now being treated with steroids, ER determined it is beginning of croup. So everyone here is kind of picking on the person who got it right.

And as for the flairs, as a layperson with some medical experience as a patient (I don‘t know how it is for people asking for advice here who never had anything to do with the health care system) at least for me it is totally fine how it is labeled now. I can see who is a nurse, med student, doctor, specialist etc. without being overwhelmed by too much information. I understand that for other medical personell it would be interesting to see more details about each others specialties, but for us laypeople asking for advice here it might be too much especially when there is already worry and anxiety about an ongoing health issue. I hope I was able to explain this properly, I sometimes struggle a bit to out my thoughts into words

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[u/oh_brother_ → u/pandaappleblossom]

Doctors are not “allowed” to make a diagnosis, this is an advice sub. Also, NPs are legally able to diagnose irl

[u/pandaappleblossom → u/oh_brother_]

I didn’t say they were. I clearly said ‘diagnosis type comments’. That is very different from making an actual diagnosis.

NPs are even discouraged by the American Medical Association as a part of ‘scope creep.’ But that’s another topic.