Paediatrics · History + examination

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

MediumYear 5 · Curtin style · 15 min + 2 min reading · 5 tasks

2 min reading · 15 min station · reminders at 2 min

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 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.

Your tasks are to:

  1. Take a focused history from the mother.
  2. Perform a focused examination.
  3. Request any relevant investigations and interpret the results provided.
  4. Summarise your findings to the examiner with your most likely diagnosis and differential diagnoses.
  5. Outline your management plan to the examiner.
  • Please verbalise your examination to the examiner; findings will be provided on request.

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

Ask the examiner

Say what you would examine or request, the way you would in the station. Nothing is named until you ask for it.

Whatever the examiner recognises is revealed below. Or pick a numbered item to reveal it blind.

Investigations

Ask for a category the way you would in the station: “Can 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.