Bronchiolitis in a 4-month-old with hypoxia
A branching clinical case simulation for a patient presenting with three days of coryza, now feeding poorly, with intercostal recession, respiratory rate 68 and saturations 89%. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min6 stages
- Patient
- 4 years, male
- Presenting complaint
- Three days of coryza, now feeding poorly, with intercostal recession, respiratory rate 68 and saturations 89%.
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are the junior doctor in a district general hospital emergency department. A mother brings her 4-month-old son, Oliver, with a 3-day history of runny nose, cough and now poor feeding. On arrival, he is breathing fast and shows intercostal recession. Pulse 160, respiratory rate 68, SpO2 89% in air, temp 37.5C. The mother is anxious. You must assess, diagnose and decide on management.
What this case teaches
Diagnose bronchiolitis clinically; assess severity by feeding, work of breathing and saturations; give supportive care and oxygen; know that bronchodilators and antibiotics do not help; decide on admission.
How the case unfolds
- 1Taking a focused historyHistory
- 2Systematic examinationExamination
- 3InvestigationsInvestigations
- 4Diagnosis and severity assessmentDiagnosis
- 5Immediate managementTreatment
- 6Admission and monitoringMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
Log in to run "Bronchiolitis in a 4-month-old with hypoxia"
A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.