Foreign-body aspiration — structured clinical encounter

Station brief (candidate)

You are the paediatric registrar in the emergency department. A 2-year-old boy is brought in an hour after a witnessed choking episode while eating peanuts: he coughed forcefully, went briefly blue, then settled and now looks well. On examination he is alert, pink and playing, afebrile, with an intermittent cough, a subtle monophonic wheeze over the right chest and slightly reduced air entry on the right. Oxygen saturations are 98 percent in air, and his chest radiograph is reported as normal. The team asks you to establish the diagnosis and the reasoning, decide on investigation and management, and set a prevention plan. You have 12 minutes with the team and 5 minutes for examiner discussion. ^[1]