Acute paeds case Flashcards
An 18mo child presents with a 3 day history of coughing and sneezing.
Their mum said that she has not been feeding as often and is finding it harder to breath
Her 4yo sister has a cold.
On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations.
What are the differentials
Viral induced wheeze
Pneumonia
Bronchiolitis
URTI
An 18mo child presents with a 3 day history of coughing and sneezing.
Their mum said that she has not been feeding as often and is finding it harder to breath
Her 4yo sister has a cold.
On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations.
What is the diagnosis and why
Viral induced wheeze
She is too young for asthma
There are no crepitations so it’s not bornchioloitis
Not an URTI as there is a wheeze
An 18mo child presents with a 3 day history of coughing and sneezing.
Their mum said that she has not been feeding as often and is finding it harder to breath
Her 4yo sister has a cold.
On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations.
She is diagnosed with Viral induced wheeze (VIW)
What is the basic pathophysiology of a viral induced wheeze
Virus causes the bronchi to contract, so you get a lovely wheeze
An 18mo child presents with a 3 day history of coughing and sneezing.
Their mum said that she has not been feeding as often and is finding it harder to breath
Her 4yo sister has a cold.
On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations.
She is diagnosed with Viral induced wheeze (VIW)
How should she be managed
Get a senior’s review
Start her on MDI salbutamol
Observe
An 18mo child presents with a 3 day history of coughing and sneezing.
Their mum said that she has not been feeding as often and is finding it harder to breath
Her 4yo sister has a cold.
On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations.
She is diagnosed with Viral induced wheeze (VIW)
She presents a few days later with tachycardia, tachypnoea and low O2 sats.
How should she now be urgently managed
Oxygen
Nebulised salbutamol & oral steroids
IV fluids
Capillary/venous gas
