Pediatrics
What OMRSE tests
Pediatrics tests normal growth and development, neonatal problems, common infections, dehydration, asthma, and immunization. The pediatric emphasis is age-specific assessment: feeding, respiratory effort, hydration, and safeguarding.
Core rules
- Bronchiolitis is a clinical diagnosis in infants under 2 years; routine chest X-ray, blood tests, and antibiotics are not indicated.
- Assess feeding, urine output, work of breathing, apnea, and oxygen saturation rather than relying on fever height.
- Use weight-based drug dosing and check for dehydration before prescribing.
- In any infant with poor feeding, lethargy, or apnea, escalate care regardless of a normal temperature.
Worked example
An 8-month-old with 3 days of coryza presents with wheeze, crackles, respiratory rate 58/min, subcostal recession, oxygen saturation 91% in air, and feeding at half the usual volume. This is bronchiolitis. Admit for nasal suction, oxygen if saturation stays below the local threshold, and small frequent feeds or nasogastric fluids. Do not give routine salbutamol, systemic steroids, or antibiotics. Reassess for apnea and fatigue; intubation is rare but indicated for exhaustion.
Traps that cost marks
- Treating every wheeze as asthma in a febrile infant.
- Ordering a chest X-ray for uncomplicated bronchiolitis.
- Missing dehydration because the child is not vomiting.
- Using adult vital-sign ranges or adult drug doses.