Paediatric Learning Issues - example

Identifying the serious or critically ill child is an important skill to pick up.....

Case example

2 y.o. toddler presents with acute stridor initially commencing as characteristic barking cough progressing to increasing respiratory difficulties. Partially immunised child

Examination revealed fever, inspiratory stridor, tachypnoea and tachycardia with tracheal tug, intercostal and sternal recession and symmetrically decreased air entry.

The child is administered oxygen by face mask at 6L/min and given nebulised adrenaline with a softening stridor but increased agitation. A disagreement about treatment follows and the parent refuse oral steroids and suggest penicillin instead. They also suggest natural remedies.

The patient improves by the next morning and the stridor only occurs during coughing. A second dose of steroids is given and the patient is discharged on day 3.

Learning Issues