The most severe respiratory infections usually occur in those under 3 years. The commonest causes of breathlessness in children are asthma, croup, bronchiolitis and pneumonia. There are various guidelines available to aid with your knowledge and understanding of this topic.
Having a good grasp of these conditions is also vital if you work in paediatrics over the winter months as this forms a large proportion of presentations. Being able to identify the sick children and respond as needed is an important skill.
It is also necessary to understand which children can be safely discharged and what advice should be given to the parents about when to return.
Learning Outcomes from Completing the Tasks
Differentiate between the various common causes of breathing difficulty in children to include:
Recognise and assess life-threatening airway obstruction and acute stridor.
Explain the pathophysiology of the different causes of acute stridor.
Recall the national guidelines for the management of various breathing difficulty problems in children.
LEARNING OUTCOMES FROM FACE-TO-FACE TEACHING
Propose a management strategy for a child with airway obstruction and acute stridor
Recall the algorithms for age appropriate obstruction
Demonstrate basic airway management in children
Revise the causes of breathing difficulty in children
Complete the following before the face-to-face session:
TASK 1: Stridor
Duration: 60 mins
This module from the new RCEMLearning website covers this topic in great detail for the ED doctor. To access the module click on the screenshot or link below. If you haven't been to the new website it is worth taking a minute or two to look round the website.
Task 2: Difficulty in Breathing
Duration: 60 mins
This section on the Spotting the Sick Child website covers DIB in children in great detail. The particular topics of importance here are asthma, croup, bronchiolitis and pneumonia. Please note: their new website now requires you to register (for free) to access the same material.
Task 3: BTS and NICE Guidelines
Duration: 45 mins
Refresh yourselves on these vital guidelines, as well as making a common exam question they all come up frequently in clinical practice.
We have written a series of interactive cases (wikis) with short answer questions to be answered by trainees prior to the face to face teaching sessions. Currently this is only available to East Midlands Trainees.
Answer one or two questions before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. We will also provide tutor comments. If you find good resources that answer a question why not include links in your comment.
Part of the face-to-face teaching will be spent discussing the case(s) below:
Here are some extra resources to review if you want more information:
This article summarises the changes made to the 2011 update of the BTS CAP in Children guideline. Useful if you're a bit short on time!
Pertussis / whooping cough:
RCEMLearning Croup page – this overlaps with the Acute Stridor module you completed as the first mandatory task but in simple webpage form so a good revision tool regarding acute stridor and croup.
Once you have worked through the exercises, discussed the example cases and attended the face-to-face teaching, please complete the following form: