Sam (via Mrs. Taylor Adams)

A 3-year-old boy is brought to the GP by his mother with a 2-day history of dry cough and new onset wheeze and breathlessness this morning. There is intercostal recession and reduced air entry on auscultation. Take a focused paediatric respiratory history from the mother, examine the child, and formulate an acute management plan.

1. 1Take a focused paediatric respiratory history from the mother using SOCRATES
2. 2Characterise the cough, wheeze and breathlessness including triggers and timing
3. 3Take a developmental, vaccination, past medical and family history
4. 4Assess severity and screen for red-flag features of respiratory distress
5. 5Verbalise a respiratory examination of the child
6. 6Order appropriate investigations and assess oxygenation
7. 7State a working diagnosis with relevant differentials
8. 8Formulate an acute management plan and advise the mother on monitoring and safety-netting