When your child has breathing trouble, ongoing symptoms, or unclear illness, your provider may recommend certain tests or procedures to help get answers. Here’s what they may include:
Common Tests
- Flu / RSV / COVID Test – Nose swab to check for respiratory viruses.
- Strep Test – A fast throat swab to check for strep throat.
- Urine Test – Used when fever has no obvious source.
- Blood Test – Checks for inflammation, infection, or dehydration.
- Chest X-ray – Looks at the lungs if there’s coughing or fast breathing.
- Pulse Oximeter – A painless clip on the finger or toe to check oxygen levels. Watch a video about At-Home Pulse Oximetry
Summary of test accuracy
Specificity (SP) = How well the test avoids false positives. Higher specificity = fewer “false alarms”
Sensitivity (SE) = How well the test catches true positives. Higher sensitivity = fewer missed cases
| Test | What It Checks | Sensitivity (SE) | Specificity (SP) | Notes for Parents |
|---|---|---|---|---|
| Takes 1–2 days, but more reliable than a rapid test. | Detects group A strep in the throat | ~85% | >95% | May miss some cases (false negatives); backup throat culture may be done if suspicion is high. |
| Throat Culture | Confirms strep or other bacteria | ~90–95% | >95% | More accurate than antigen tests; results may take longer, but they are very reliable. |
| Rapid Flu Test (antigen) | Influenza A/B | ~50–70% | ~90–95% | Faster but less sensitive; may miss early or mild flu cases. Best used during flu season |
| PCR for respiratory viruses | Detects viral genetic material. Comes in many forms. The rapid flu test described above is often combined with tests for RSV (since the pandemic, SARS/COVID-2 has also been included in a single swab kit. | >95% | >98% | Not diagnostic by itself, but it helps show trends. For a one-time illness, any of these swabs is appropriate; however, for repeated illnesses, there are more comprehensive panels that can test for ~a dozen viruses. |
| Urine Dipstick | Screens for UTI (leukocytes, nitrites) | ~75–85% | ~80–90% | Fast and helpful, but not definitive — needs culture for confirmation. |
| Urine Culture | Confirms UTI | >90% | >95% | Gold standard; takes 24–48 hrs to grow bacteria. |
| Blood Culture | Detects bloodstream infections | Variable (~65–85%) | >95% | Best when taken before antibiotics; sometimes negative even with illness. |
| CBC (Complete Blood Count), sometimes CRP might be added | General infection/ inflammation signs | — | — | Not diagnostic by itself, but helps show trends (e.g., high WBC count). |
| Chest X-ray | Pneumonia, fluid, inflammation | ~85–90% | ~90% | Can miss very early infections or subtle lung problems. |
| Pulse Oximeter | Blood oxygen level | High SE/SP, when used appropriately. | Standard for CF diagnosis: painless skin test. | Not diagnostic, but alerts providers to possible breathing problems. |
| Bronchoscopy | Visualizes airways, samples mucus | High (visual exam) | High | Used when less invasive tests don’t give answers. May find structural or infection issues. |
| Sweat Chloride Test | Screens for cystic fibrosis | >95% | >95% | Standard for CF diagnosis; painless skin test. |
| COVID Antigen Test | Detects viral protein | ~60–85% | ~90–95% | Good when symptoms are present, but can miss early cases. |
| COVID PCR | Detects viral RNA | >95% | >98% | Gold standard — highly sensitive and specific. |
| RSV Antigen Test | Respiratory syncytial virus | ~80% | ~90–95% | PCR is more accurate but takes longer. |
| Allergy Skin Test | Reaction to allergens | ~90% (for inhalants) | ~50–80% | Can be affected by meds, skin sensitivity, or age. Not helpful during infection. |
| Allergy Blood Test | Sensitization to allergens | Lower than skin test | Better than skin tests | Blood tests can be positive in infancy – in contrast to skin tests, which are typically not positive until school age, even in the face of allergy. |
Common Procedures
- Bronchodilator inhalation may be delivered by:
- Nebulizer Treatment – Delivers mist medication to open your child’s airways.
- Inhaler with Spacer – A quick-relief tool for wheezing or asthma-like symptoms.
- Nasal Suctioning – Clears mucus in babies or very congested kids.
Less Common, But Important Procedures
These are rarely needed but may be used if symptoms don’t improve, are severe, or don’t have a clear cause.
- Bronchoscopy
A small camera is passed through the nose or mouth into the lungs (under sedation). It lets the doctor see the airways and collect samples.
✅ Used for chronic cough, unusual infections, or airway blockage concerns. - Lung Ultrasound or CT Scan
Used if an X-ray doesn’t give clear answers — can help spot fluid around the lungs, abscesses, or structural issues. - Sweat Chloride Test
A painless skin test that checks for cystic fibrosis. It may be done if there are frequent lung infections or poor weight gain. - Allergy or Immunology Testing
It may be considered if your child has ongoing wheezing or frequent colds that don’t follow normal patterns. - Sleep Study (Polysomnography)
A monitored overnight test to evaluate breathing, snoring, or oxygen drops during sleep.
What to Expect
Your provider should always explain:
- Why a procedure is recommended
- What your child may feel (e.g., asleep, numb, or just ticklish)
- Whether it can be done in the clinic, ER, or hospital
- How soon you’ll get results
You can always ask:
💬 What’s this for?
💬 Is it safe?
💬 What happens if we wait?
