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Respiratory failure and respiratory distress are both medical emergencies that demand prompt treatment and present special dangers to vulnerable groups such as children, elders, and people with chronic illnesses. Respiratory distress, for example, affects about 1% of newborns and is the leading cause of death in neonates born prematurely.


Respiratory Failure vs. Respiratory Distress: What’s the Difference? 

Respiratory distress happens when a person is unable to regulate gas exchange, causing them to either take in too little oxygen or expel too little carbon dioxide.


Respiratory failure can follow respiratory distress and causes more severe difficulties with gas exchange. Left untreated, it may be fatal. Most causes of respiratory failure are obstructive. Chronic obstructive pulmonary disease (COPD) is the leading cause of chronic respiratory failure. Acute respiratory failure often follows an illness or injury, such as a drug overdose, pneumonia, or a severe infection such as COVID-19. 


Respiratory distress and failure are serious ailments that may foretell bad outcomes, even in patients who seem otherwise healthy. About two-thirds of people with respiratory distress develop impaired pulmonary function one or more years following their recovery. So it is important to refer patients for follow-up care and to advise them that, even after recovery, respiratory impairments may be a sign of serious medical problems.


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Signs and Symptoms of Respiratory Distress

Respiratory distress is dangerous primarily because it increases the risk of respiratory failure. The two symptoms thus exist on a continuum. Some signs and symptoms of respiratory distress include:


  • Rapid, shallow breathing
  • Panic 
  • Tachycardia 
  • Increased respiratory effort
  • In infants, nostril-flaring, retractions, and increased respiratory sounds 
  • Pallor
  • No breathing sounds


Signs and Symptoms of Respiratory Failure 

Respiratory failure can look considerably similar to respiratory distress. One hallmark of respiratory failure, however, is agonal breathing – when a person appears to be breathing but is either not taking in oxygen, not expelling carbon dioxide, or breathing at an abnormal rate. A person with agonal breathing may struggle to breathe or gasp. 

 Some other symptoms of respiratory failure include


  • Blue tint to the lips, skin, or nails
  • Shallow breathing 
  • Hypercapnia 
  • Increased breathing sounds such as gasping or gurgling 
  • Hypoxia 
  • Bradycardia 
  • Loss of consciousness
  • Heart arrhythmias
  • Excessive or profuse sweating
  • Changes in consciousness or difficulty communicating 
  • Fatigue, anxiety, or panic
  • Rapid breathing
  • Gasping for air


As respiratory failure worsens, a person may exhibit no effort to breathe or stop breathing altogether. People in respiratory distress, by contrast, continue exerting immense effort to breathe.


Diagnosing the Issue

Determining whether the problem is with ventilation, oxygenation, or both, can help with guiding treatment decisions. Some questions to ask include: 


  • Is the person physically able to breathe, and are the chest muscles functional? 
  • Is there a central nervous system issue?
  • Is the rate of respiration adequate? 
  • Is there adequate blood flow in the lungs? 
  • Is there adequate gas exchange? 
  • Is there a visible injury, or a chronic illness that might explain the symptoms?
  • What is the patient’s medical history?

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The Importance of Choosing the Right Equipment

Maintaining a patent airway is critical to the survival of people who are experiencing respiratory emergencies. Protecting the airway can prevent respiratory failure by buying time and reducing damage to the brain and other vital organs.


Portable emergency suction enables medical providers to treat patients wherever they need care, without delaying treatment or undertaking the risk of moving a patient who is already facing a crisis. The right equipment saves lives and improves care outcomes. For help choosing the option that’s right for your organization, download our free e-book, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.


Editor's Note: This blog was originally published in July 2020. It has been re-published with additional up to date content.