Patients with respiratory failure usually appear distressed with altered mental status. Physical examination of patients with respiratory failure is usually remarkable for dyspnea, stridor, and tachypnea.

Physical examination of patients with respiratory failure is as follows:^[1][2]

Patients with respiratory failure usually appear distressed with altered mental status

• Tachycardia
• Arrhythmia
• Tachypnea

• Cyanosis
• Bruises
  • May be due to insult to the neck or thorax
• Clubbing
• Rashes
  • May suggest atopy

• Evidence of trauma
• Ophthalmoscopic exam may be abnormal with findings of papilledema
• Flared nares
• Nasal polyps
  • May suggest atopy or aspirin-induced asthma

• Bruises
• Elevated jugular venous pulse

• Fine crackles upon auscultation of the lung bases bilaterally
• Evidence of preexisting lung disease may also be present such as:
  • Paradoxical thoraco-abdominal breathing
  • Wheeze
    • Typically absent and secondary to severe airway obstruction, representing a silent chest
  • Persistent scattered rhonchi
  • Prolonged expiration
  • Diffusely decreased breath sound
  • Coarse crackles with inspiration

• Altered mental status
• Clonus
  • May be present

• Cyanosis
• Peripheral edema