Respiratory problems are a significant cause of cardiopulmonary failure leading to cardiac arrest in infants and children. The distinction between respiratory distress and respiratory failure may not be made with a clinical history and physical examination alone. Ancillary testing, such as arterial blood gas analysis, is necessary. 

In a seriously ill child with a medical condition that deteriorates quickly, respiratory failure can result even without respiratory distress. If respiratory failure progresses to cardiac arrest, poor outcomes are probable. Therefore, the PALS provider should treat a seriously ill child through prompt recognition of respiratory problems and intervene immediately to prevent cardiopulmonary failure that leads to cardiac arrest.