Intercostal retractions

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Retractions of the chest muscles

This is an emergency requiring immediate medical attention.

• Intercostal retractions occur. This can be a sign of airway obstruction, which can quickly become life-threatening.
• Other symptoms are also present. If the skin, lips, or nailbeds are blue, or if the person becomes confused, drowsy, or hard to awaken, this is an emergency situation!

In emergency situations, interventions will be taken first to help with the breathing. This may include oxygen, medications to reduce swelling, or other measures.

When the condition is stable enough to allow it, the history will be obtained and a physical examination performed to determine the cause of the airway obstruction.

Medical history questions documenting intercostal retractions in detail may include:

• Time pattern
  • When did it start?
  • Is it getting better, worse, or staying the same?
  • Does it occur all the time?
• Intensity
  • How bad is it?
• History
  • 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?
  • Have you seen the child putting anything in the mouth that might have been inhaled into the airway?
  • What other symptoms are also present? Especially, 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
• Laboratory tests, such as a CBC
• Other tests depending on the suspected cause

Review Date: 05/10/2006
Reviewed By: Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.