Serena is a young girl aged 20 months.Her parents have brought her to the emergency department of their local hospital at approximately 0200 hours.

Serena is a young girl aged 20 months.Her parents have brought her to the emergency department of their local hospital at approximately 0200 hours.

Serena is a young girl aged 20 months.Her parents have brought her to the emergency department of their local hospital at approximately 0200 hours. On admission the medical record notes the following assesment:
20/12 female child,with a 2/7 history of sore throat,fevers, and profuse nasal discherge.
Parent report that ealier this evening,she developed a barking cough and has had increasing difficult
breathing patient history:well child.No prior admission/presentations.
On examination:Pale, peripherally warm,irritable.marked inspiratory stridor.Mild intercostal recention & use
of abdominal muscles.Influence barking cough.Profuse nasal secretions Oxygen saturation:93% in room air
respitory Rate: 32/minute, Heart Rate:162/minutes. Temp: 38.9 c per axilla Weight 11.4 kilograms Diagnosis:
Viral group.
Plan:Oral corticosteroid may reguire oxgygen therapy to maintain oxygen saturation above 95% observe fluid
intake and output. Admit to children ward Ressess in 4 hours.

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