What is the primary indicator of inadequate breathing in children?

The primary indicator of inadequate breathing in children is the use of accessory muscles. When a child's respiratory system is compromised, they may work harder to breathe, which can lead to the engagement of secondary muscles located in the neck and chest. The use of these accessory muscles suggests that the child is struggling to inhale sufficient air, indicating respiratory distress.

This can be observed through the presence of retractions—where the skin over the ribs or clavicle pulls in with each breath—showing that the child is expending significant effort just to breathe. Recognizing this sign is crucial, as it prompts immediate assessment and intervention, as the child's condition may deteriorate if not addressed promptly.