Presentation

Respiratory Distress / Cough

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.

Vignette

A 6 year old boy is brought to the emergency department due to a persistent cough over the last 1-2 weeks, and is now having some difficulty breathing

Diagrams

Pre-Clerkship

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.

Lectures

Small Groups

  • Pediatric Respirology Cases 1, 2 and 3 Course 3
  • Pediatric Congestive Heart Failure Course 3
  • Peds ID: Common Infections Course 6
  • Pediatric Emergency Medicine Course 6

Clerkship

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.

Objectives

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

  1. Propose a management plan for patients with an acute exacerbation of asthma. List triggers of an acute exacerbation of asthma.
  2. Explain physiologic rationale for out-patient treatment of asthma. Propose a management plan for patients with anaphylaxis, croup, bronchiolitis, and pneumonia.
  3. Recognize the clinical features of pertussis, epiglottitis, tracheitis, foreign body, cystic fibrosis, and congestive heart failure.

Half Day Cases

  • A 3 year old girl is brought in to the emergency department for increased work of breathing. Her initial vitals showed heart rate of 130, respiratory rate of 40, oxygen saturation 86% on room air, blood pressure 92/46, temperature 38 celcius
  • A 3 month old girl is brought in to the emergency department for increased work of breathing. Her initial vitals showed heart rate of 180, respiratory rate of 70, oxygen saturation 86% on room air, blood pressure 80/46, temperature 38 celcius
  • A 2 year old child is brought into the emergency department by EMS. He was playing at home, and then developed sudden onset of stridor and increased work of breathing.
  • A 7 year old boy has had a persistent for for 4 months now.

Resources

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.

Papers 

  • Kovesi T et al. Achieving control of asthma in preschoolers. . CMAJ.
    2010; 182 (4): E172-184.
    Outlines chronic management of asthma. .
  • Canadian Thoracic Society asthma management continuum – 2010 consensus summary for children six years of age and over, and adults. Lougheed MD et al.
    Canadian Respirology Journal 2010; 17(1): 15-24..
  • Canadian Thoracic Society 2012 guideline update: Diagnosis and management of asthma in preschoolers, children and adults. . Lougheed MD et al.
    Canadian Respirology Journal 2012; 19(2): 127-164..
  • Managing the paediatric patient with an acute asthma exacerbation.
    https://www.cps.ca/en/documents/position/management-acute-asthma-exacerbation
    Canadian Paediatric Society Position Standard (2012) Outlines management of acute asthma exacerbation. .
  • You Can Control Your Asthma.
    https://www.ucalgary.ca/icancontrolasthma/
    () Website for families about how to control asthma – translated into 11 different languages! .
  • Pneumonia in healthy Canadian children and youth: Practice points for management.
    https://www.cps.ca/en/documents/position/pneumonia-management-children-youth
    Canadian Paediatric Society Practice Point (2011) Outlines etiology, clinical presentation, investigation and management of community acquired pneumonia. .
  • Bronchiolitis: Recommendations for diagnosis, monitoring and management or children one to 24 months of age.
    https://www.cps.ca/en/documents/position/bronchiolitis
    Canadian Paediatric Society Position Standard (2014)
  • Emergency treatment of anaphylaxis in infants and children.
    https://www.cps.ca/en/documents/position/emergency-treatment-anaphylaxis
    Canadian Paediatric Society Position Standard (2011) Outlines clinical presentation and management of anaphylaxis. .

Videos 

No videos.

Clinical approaches to Respiratory Distress / Cough?

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Last updated 09 August 2021.