Paeds Cases · acute-care-resuscitation-and-toxicology
Oxygen, high-flow and non-invasive respiratory support — OSCE
OSCE assessment and communication station for a child with bronchiolitis escalating to high-flow nasal cannula, with an anxious parent.
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You are the paediatric registrar in the emergency department. A 5-month-old infant has been brought by ambulance with a 2-day history of coryzal illness and worsening breathing. Standard low-flow nasal cannula oxygen at 2 L/min has been started by the triage nurse, but the infant remains in distress. [7]
You have 10 minutes to: assess the infant's respiratory status using a structured approach; decide on the appropriate level of respiratory support and state the starting parameters; explain your plan to the infant's parent, who is visibly anxious; and outline your reassessment and escalation plan. A buzzer will sound at 8 minutes. [7]
References4ShowHide
- [1]Franklin D A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis. N Engl J Med, 2018.PMID 29562151
- [4]Ramnarayan P Effect of High-Flow Nasal Cannula Therapy vs Continuous Positive Airway Pressure Therapy on Liberation From Respiratory Support in Acutely Ill Children Admitted to Pediatric Critical Care Units: A Randomized Clinical Trial. JAMA, 2022.PMID 35707984
- [7]Milési C Clinical practice guidelines: management of severe bronchiolitis in infants under 12 months old admitted to a pediatric critical care unit. Intensive Care Med, 2023.PMID 36592200
- [9]Emeriaud G Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2). Pediatr Crit Care Med, 2023.PMID 36661420