Child DIB Scenario

What characteristics would you assess under the Appearance element of the triangle? 

The baby is alert but appears lethargic, irritable, and inconsolable when handled. He looks pale and is breathing with effort. Initial observations: HR 170, SpO₂ 91%, RR 50, Temp 37.8°C, BM 4.5 mmol/L. 

Can you use NEWS2 to determine the likelihood of deterioration? 

You apply oxygen with the mother’s help and listen to the chest. You hear high-pitched expiratory wheeze with occasional inspiratory wheeze. You consider salbutamol. 

Is it indicated within this scenario context? 

The child has had low-grade fever for three days, persistent cough, and poor feeding for 24 hours with vomiting after feeds. Based on this, what is the most likely diagnosis? 

You suspect bronchiolitis. What further treatment could a pre-hospital clinician provide? 

You use the POPS score to assess deterioration risk. With no significant past medical history and low-level concern, what is the likely score? 

The SpO₂ improves slightly to 93% as the mother holds the mask near the baby’s face. What should the ongoing management be? 

While waiting for the Ambulance crew, what further useful questions could you ask the mother? 

The crew arrives and agrees with your assessment. What hospital treatment is most likely? 

What causes bronchiolitis? 

Which features may distinguish pneumonia from bronchiolitis? 

What age group is typically affected by bronchiolitis? 

Which patients should automatically be transferred for further assessment if bronchiolitis is suspected? 

Should parental concern alone warrant hospital transfer? 

If the situation was different and the child was much better in presentation and history, where discharging at home, what points should be factored in?