The evaluation of someone with breathing difficulty begins with a history and physical examination.

Physical findings in someone with breathing difficulty may include:

• Signs of severe difficulty breathing:
• Rib retractions
• Nasal flaring
• Use of accessory muscles
• Cyanosis
• Dry mucous membranes and skin, or other signs of dehydration
• Fever
• Rapid pulse
• Rapid breathing
• Congestion in the chest:
• During examination with a stethoscope
• Wheezing

Tests are often necessary to determine the underlying cause for the breathing difficulty.

Tests that may be used to evaluate breathing difficulty include:

• Complete blood count: helps assess the severity of infection
• Chest x-ray:
• Normal chest x-ray
• Chest x-ray showing pneumonia
• Pulse oximetry: may show low oxygen levels
• Blood cultures:
• Detects bacteria that have spread into the bloodstream
• Bronchoscopy:
• Can obtain sputum for bacterial cultures, clear the airway, or retrieve a foreign body
• Cultures of sputum (mucus) for bacteria and viruses
• Rapid influenza testing
• Urine antigen testing for pneumococcus or Legionella
• Pulmonary function tests