Sick bronchiolitic child
6 month old in respiratory failure
candidate brief
The triage nurse has just triaged a child who she is worried about - she has moved the child to a majors cubicle but would like you see her straight away.
actor brief
Sophie, 6 months old with mother
She has been unwell for 2-3 days - cough/coryza
Off food since yesterday, only taking small amounts of milk where usually she would have purees
Fewer wet nappies today
You felt she was working harder to breathe today so brought her in
examiner brief
Initial obs:
tracheal tug, subcostal recessions, head bobbing, RR 40, spO2 88% on air → 92-93% on wafting oxygen
mottled appearance, crt = 2s, HR 160, BP 90/60
crying and unsettled
- washes hands, introduces self
- ensures child is in appropriate clinical area
- takes appropriate handover
- takes brief history from mother
- past medical history
- drug history
- allergies
- A/B: recognises resp distress
- applies oxygen
- thinks about optiflow
- Circulation assessment
- IV access
- starts appropriate investigations - gas, bloods, culture, viral swab
- communicates plan to parent
- handover to paeds team
- global mark