A regular pattern of inhalation and exhalation. Muscle retractions above the clavicles and between the ribs. You arrive to find her in obvious distress, laboring to breathe. In one-word sentences she tells you she has a history of asthma, but does not have her medication with her. It is 2100 hours when you receive a call for a child with difficulty breathing.
Mom states the child has been complaining of a sore throat and coughing.
The child's coughing has increased this evening and sounds like a barking seal. The child is anxious and is using accessory muscles to breathe. She states her problem began about 15 minutes ago after an argument with her boyfriend. Breath sounds are clear bilaterally with equal rise and fall of the chest. The patient has no allergies and takes no medications regularly.