Cough, fast breathing and poor feeding in an 8-month-old - Emergency Department

CurtinYear 515 min + 2 min readingPaediatrics & neonatologyStandardPre-internship
  • Focused history
  • Focused examination (respiratory, hydration 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 in July.

Nyibol Mading, aged 8 months, has been brought in by her mother, Adut, with three days of a runny nose and cough and, since last night, fast noisy breathing and poor feeding. The triage nurse has recorded observations and weight. The baby is on her mother's lap; the mother will give the history, and examination findings will be provided by the examiner as you verbalise each step.

Observations at triageRespiratory rate 62 /min, SpO2 91% on room air, heart rate 156 /min, temperature 38.1 degrees C, weight 8.5 kg
Triage note8-month-old. Coryza and cough 3 days, increased work of breathing overnight, feeding reduced. 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 baby, including her general appearance, work of breathing, chest and hydration. 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 management plan to the examiner, and explain the diagnosis and 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 say explicitly what you would not give and why.
  • 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.