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 now if your baby:
Has blue, grey, or very pale lips or skin
Is struggling to breathe or has pauses in breathing
Is limp, difficult to wake, or unresponsive
Suddenly deteriorates after a chest injury
Has severe chest retractions or cannot feed because of breathing difficulty
Do not drive a severely unwell baby yourself if emergency transport is available.
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
A newborn or young infant with new breathing difficulty needs prompt medical assessment.
Seek urgent same-day medical care for persistent fast breathing, grunting, widening nostrils, reduced feeding, unusual sleepiness, or skin pulling in around the ribs.
These signs have several possible causes and do not confirm pneumothorax, but they should be assessed.
3
Does any of this apply?
Book an appointment
After discharge, contact the baby's healthcare team routinely if you have questions about feeding, activity, follow-up imaging, travel, or the healing site from a chest drain.
Routine follow-up is also appropriate when breathing is comfortable but mild concerns are not improving.
Every sign above is quoted from the sofidex article on Pneumothorax - infants. If you are not sure, err upward — it is always reasonable to be checked.