Vomiting and diarrhoea in a drowsy 2-year-old - Emergency Department

CurtinYear 515 min + 2 min readingPaediatrics & neonatologyStandardPre-internship
  • Focused history
  • Focused examination (hydration assessment, abdomen and general appearance)
  • Request investigations
  • Dx + differentials
  • Initial Mx
  • Paediatric history

Ready

2 min reading, 15 min station, warning at 2 min

Focus the timer and press Space to start or pause.

Station - Instructions for candidate

You are an intern working in the paediatric Emergency Department of a metropolitan hospital in Perth.

Isla Brennan, aged 2 years, has been brought in by her mother, Kate, with two days of vomiting and diarrhoea. Observations and a weight have been recorded. The child is on her mother's lap; her mother will give the history, and examination findings will be provided by the examiner as you verbalise each step.

Observations at triageHeart rate 150 /min, respiratory rate 30 /min, temperature 37.8 degrees C, blood pressure 92/58 mmHg, SpO2 99% on room air, weight 12.0 kg
Triage noteVomiting and diarrhoea 2 days, drowsy at triage. Mother reports weight 12.8 kg at the child health nurse three weeks ago. Category 3.

Your tasks are to:

  1. Take a focused history from the mother, including the relevant paediatric background.
  2. Perform a focused examination of the child, including her general appearance, hydration status and abdomen. Verbalise each step to the examiner and the findings will be provided.
  3. Request any investigations you would order. The examiner will tell you whether they are indicated and provide results where appropriate.
  4. State your most likely diagnosis and the differential diagnoses to the examiner.
  5. Outline your initial management plan to the examiner, including fluid volumes for this child, and explain the plan to the mother.
  • You do NOT need to summarise your history and examination findings to the examiner.
  • State drug, dose and route where relevant, and show your fluid calculations aloud.
  • The examiner may hand you results at any point after you request them.

This is a 15-minute station, with 2 minutes of reading time.

Ask the examiner

Say what you want out loud, then open it below. Each result stays hidden until you reveal it.

Investigations

Ask for a category the way you would in the station: β€œCan I have the obs and a set of bloods?”

Examination

Say what you would examine and how; the examiner reports what you would find.

After treatment

Once you have acted, ask how the patient has responded.

Generated by AI for practice; check doses and pathways against eTG / AMH before relying on them.