Acutely Ill Child

Key Conditions

Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.

Clinical Approach

Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.


A 14 year old girl is brought to the emergency department by her parents after she became acutely unwell at school



Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.


Small Groups

  • Diabetic Emergencies Course 4
  • Pediatric Emergency Medicine Course 6
  • Pathogenesis of Diabetes Course 5
  • Diabetic Emergencies Course 4


Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.


By the end of the Paediatric Clerkship, a medical student will be able to:

  1. Recognize and initiate treatment of an acutely ill child.
  2. Calculate the fluid deficit and write orders for management of a paediatric patient with: burn, shock, and diabetic ketoacidosis.
  3. Identify signs and symptoms of a surgical abdomen.
  4. Clinically recognize signs and symptoms of poisoning / intoxication and propose an investigation and management plan for patients with acetaminophen toxicity.
  5. Clinically recognize meningococcemia and describe a management plan.
  6. Propose a management plan for a paediatric patient with trauma including primary and secondary surveys, and use of Broselow tape.

Half Day Cases

  • A 1 year old boy presents with complaint of cough and difficulty breathing. He has a 2 day history of nasal congestion and low grade fever.
  • A 3 month old girl presents with a 2 day history of severe difficulty breathing.
  • A 15 month old boy presents with a 24 hour history of vomiting and diarrhea (watery, with pus and blood). Child is now listless.
  • A 6 month old girl is brought to ED after “falling from bed” onto carpeted floor. Baby is now “sleepy” according to mother.
  • A 4 year old boy fell off a playground structure 6 feet off the ground. He struck his head and may have lost consciousness.
  • A 16 year old boy is found unconscious in the locker room at school.


The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.


  • APLS: The pediatric Emergency Medicine Resource.
    Fifth Edition. American Academy of Pediatrics, American College of Emergency Physicians, 2012; .
  • Intravenous Fluid Management for the Acutely Ill Child. Moritz ML et al.
    Current Opinion in Pediatrics 2011; 23, 186-193..


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