Wheezing

Alternative names:

sibilant rhonchi

Home care:

Drink plenty of fluids. It is best to drink water, but fruit juices or soft drinks may be used if this will increase the amount of liquids taken.

Use a cold mist vaporizer. If a vaporizer is not available, the shower may be used to produce a mist. Unfortunately, it is difficult to get much vapor down to the small breathing tubes.

Call your health care provider if:

• wheezing occurs in the presence of a fever.
• wheezing is a recurrent, unexplained problem.
• wheezing is caused by an allergic reaction to a bite or medication.
• wheezing is associated with significant shortness of breath, bluish skin color, or mental status changes.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting wheezing in detail may include:

• time pattern
  • When did the wheezing begin?
  • How long does it last?
  • Does it occur often?
  • Does it occur daily?
  • What time of day does it occur?
  • Is it worse at night or in the early morning?

• quality
  • What does the wheezing sound like?
  • Does it make breathing difficult?
  • Does it require stopping all physical activity?
  • Does it resolve without treatment?

• aggravating factors
  • What seems to cause it?
    • Eating certain foods?
    • Taking certain medications?

  • What makes it worse?
    • Exercise?
    • Stress?
    • Exposure to pollens, insects, dust, chemicals (perfumes, cosmetics)?
    • Exposure to cold air?
    • Cold or flu?

• relieving factors
  • What helps relieve it?
    • Rest?
    • Medications such as bronchodilators?

• other symptoms
  • What other symptoms are also present?
  • Is there a fever?
  • Is there coughing?
  • Is there swelling of the lips or tongue?
  • Is there panic or confusion?
  • Is there loss of voice?
  • Is there loss of consciousness?
  • Is there a bluish color to lips or nailbeds?
  • Is there nasal congestion?
  • Are there puffy, red eyes?
  • Is there an insect bite?
  • Has there been an episode of choking?

• additional information
  • Is there a history of asthma or allergies?
  • What medications are being taken?
  • Has there been exposure to tobacco smoke?
  • Has there been a recent illness?

The physical examination may include listening to the lung sounds (auscultation). The possibility that foreign material has been swallowed may also be investigated in small children.

Diagnostic tests that may be performed are:

• chest X-ray
• blood studies, possibly including arterial blood gases

Intervention:
Drugs to open up the breathing tube, such as adrenalin or aminophylline, may be given by inhalation, aerosol, injection, by mouth, or by rectal suppository. Hospitalization should only be necessary if fluids need to be given intravenously or if humidification can't be achieved in any other way. In any case, the patient will need to be closely watched. Hospitalization may be required as a precautionary measure to prevent the condition from getting worse.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to wheezing, you may want to note that diagnosis in your personal medical record.