Exam by body system

How to assess a child in respiratory distress

Other platforms explain it with text and video. In VMS you practice it on the patient.

MD / DOPANursing (NCLEX)
Practice it in VR with Blocky

Children compensate well and then tire quickly. Look before you touch.

Step by step

  1. Appearance

    Alert, interacting, or drowsy and floppy (urgent). [1]

  2. Work of breathing

    Fast breathing, nasal flaring, retractions, head bobbing, grunting. [1]

  3. Sounds

    Stridor (upper airway), wheeze (lower), crackles. [1]

  4. Color and saturation

    Pale or blue; saturation below about 92% needs oxygen. [1]

  5. Position

    Sitting forward, drooling: do not upset the child (epiglottitis). [1]

  6. Act

    Oxygen as tolerated, keep the child with the parent, call for help. [1]

Common errors

Practice it in VMS

In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

VMS cases that train this skill

14 VMS cases train this skill: open the case library

Sources

  1. NASEMSO National Model EMS Clinical Guidelines
  2. NCCPA PANCE Content Blueprint
  3. Stanford Medicine 25 (bedside exam)
  4. Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)

Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). VMS is not affiliated with these organizations. Updated: 2026-10-11.