Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services if retractions occur with any of the following:
Blue, grey, or very pale lips, tongue, or face
Pauses in breathing or an irregular breathing pattern
Severe difficulty speaking, crying, or making sounds
Inability to drink because of breathlessness
Marked drowsiness, confusion, limpness, or difficulty waking
Choking or suspected airway blockage
Swelling of the lips or tongue, hives, or sudden breathing difficulty
Breathing that is rapidly worsening despite a prescribed rescue plan
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek urgent medical assessment now if retractions are new, continue while resting, or occur with fast or difficult breathing.
This is particularly important for babies, young children, older adults, and people with lung or heart conditions.
Do not wait for a routine appointment when retractions are present at rest.
3
Does any of this apply?
Book an appointment
If an episode has fully resolved but keeps returning, arrange a routine appointment to discuss possible triggers and whether further assessment is needed.
Every sign above is quoted from the sofidex article on Intercostal retractions. If you are not sure, err upward — it is always reasonable to be checked.