Red flags & when to go in person for Wheezing in Children

Audience: pediatric

Wheezing in children is a high-pitched sound often heard when breathing out and may signal narrowing or blockage in the airways. It can be caused by conditions like asthma, infections, or allergies. Telemedicine can help assess mild wheezing and guide families on managing symptoms at home. However, some signs mean a child needs urgent in-person care to avoid serious complications. Knowing the red flags helps parents decide when to seek emergency help. This guide explains when telemedicine is suitable, what signs require immediate medical attention, and how to prepare for a tele-visit. It also covers common questions about wheezing in children to support safe and timely care.

Red flags — go in person / ER

• Child has difficulty breathing that is worsening or very fast.
• Lips, face, or nails turn blue or gray (signs of low oxygen).
• Child is very sleepy, difficult to wake, or confused.

What telemedicine can do

• Mild wheezing with no severe breathing difficulty.
• Routine follow-up for known asthma or wheezing conditions.
• Guidance on home care and medication use.

What telemedicine cannot do

• Severe breathing difficulty or distress.
• Signs of low oxygen such as blue lips or face.
• Altered consciousness or inability to respond normally.

What is Wheezing in Children?

Wheezing is a whistling or squeaky sound when a child breathes, usually when exhaling. It happens when the small airways in the lungs become narrow or blocked. Causes can include asthma, respiratory infections, allergies, or inhaling irritants. Wheezing can range from mild to severe and may come with coughing or difficulty breathing.

When to Use Telemedicine for Wheezing

Telemedicine can be helpful for mild wheezing without severe symptoms. A healthcare provider can ask about your child's symptoms, watch their breathing over video, and advise on home care or medicines. This can save time and reduce exposure to other illnesses. Telemedicine is often suitable when your child is breathing comfortably and able to speak or play.

Red Flags That Need In-Person Care Immediately

Some signs mean your child needs urgent medical attention:

If you see any of these, call emergency services or go to the nearest emergency room right away.

Preparing for a Telemedicine Visit

To get the most from your tele-visit:

After Your Telemedicine Visit

Follow the healthcare provider's advice carefully. This may include giving medicines, monitoring symptoms, or scheduling an in-person visit if needed. Watch for any worsening signs and seek emergency care if red flags appear. Keep a record of symptoms and treatments to share at follow-up visits.

How to prepare for your tele-visit

• Ensure a stable internet connection and a device with video capability.
• Have your child's medical history and current medications available.
• Note the start time and triggers of wheezing symptoms.
• Prepare a list of symptoms and any questions for the provider.
• Find a quiet, well-lit area for the telemedicine visit.

After your tele-visit

• Follow the healthcare provider's instructions for medications and care.
• Monitor your child's breathing and overall condition closely.
• Seek emergency care if any red flag symptoms develop.
• Schedule follow-up appointments as recommended.
• Keep a symptom diary to track changes and treatment response.

FAQs

What causes wheezing in children?

Wheezing is caused by narrowing or blockage of the small airways in the lungs. Common causes include asthma, respiratory infections like bronchiolitis, allergies, or inhaling irritants such as smoke.

Can telemedicine diagnose the cause of wheezing?

Telemedicine can help assess symptoms and guide initial care, but it often cannot replace physical exams or tests needed to diagnose the exact cause. In-person visits may be necessary for a full evaluation.

How can I help my child breathe easier at home?

You can help by keeping your child calm, using prescribed inhalers or nebulizers as directed, and avoiding triggers like smoke or allergens. Always follow your healthcare provider's advice.

When should I go to the emergency room for wheezing?

Go to the emergency room if your child has severe difficulty breathing, blue lips or face, is very sleepy or unresponsive, or cannot speak or cry due to breathlessness. These are signs of a medical emergency.

Is wheezing always a sign of asthma?

Not always. While asthma is a common cause, wheezing can also result from infections, allergies, or other conditions. A healthcare provider can help determine the cause.

Sources

1. Wheezing in Children — MedlinePlus, U.S. National Library of Medicine.
2. Asthma in Children — Centers for Disease Control and Prevention (CDC).
3. Wheezing and Respiratory Distress — Mayo Clinic.
4. Pediatric Wheezing: Diagnosis and Management — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child shows any signs of severe illness or if you are concerned, seek immediate medical attention.