Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 2 year old respiratory distress?27 month old female, 27 lbs. Meds: duoneb, albuterol sulfate, epi pens. History: born at 31 weeks, required extensive oxygen support including ventilation for a few weeks. Allergies to eggs, peanuts, coconut, sunflower, dogs.2 year old is on day 3 of a relatively minor cold. She is covid negative as is the rest of the family (we tested for Christmas.) Over night started having a little trouble breathing. Resting resp. rate was between 36 and 40 breaths per minute. Grunting occasionally, minor retractions in rib cage and clavicle. No fever, no vomiting, normal energy all day prior. Normal appetite, normal diaper count. Gave duoneb breathing treatment and noticed slight improvement. (Resp rate went from 40 to 36 bpm.)Does this warrant an ER visit? With covid surging Im hesitant to bring a not yet vaccinated former preemie anywhere she could be exposed. My Childrens hospital offers an e visit option but I feel like this is something theyd need to see and or hear for themselves in person.. ### Response: That resp rate is close to normal for her age. The concerning part is the grunting and retractions. That signals she's working hard to breathe. Given her medical history it would be a good idea to have her seen by a doctor. She may need a change to her baseline inhaled medications if she's dealing with a cold..