Welcome to the Emergency Medicine Cases podcast.

I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC Studios in Toronto.

There's no immediate need to make that quick diagnosis.

You'll probably be getting a urine on any kid between one in three months who's febrile, whether

they have bronchialitis or not.

It's really about the respiratory status and the hydration status.

There's steroids, there's epinephrine, there's hypotonic saline, there's ketamine,

there's heliocs, there's aonic saline, there's ketamine, there's heliox,

there's this whole laundry list of medications that we could potentially use for bronchiolitis.

The SAT for me is the first vital sign that nobody ever really wanted and that we're stuck with.

Asthma, broncholitis and croup are some of the most common diagnoses we make in both general and pediatric edes.

And like many pediatric illnesses, there's a wide spectrum of severity of illness, as well as a huge variation in practice in treating these children.

These respiratory illnesses rarely need any workup, yet a lot of resources are used unnecessarily.

We need to know when to worry about these kids, as most of them will be fine with simple

interventions, but a few will require complex care. Sometimes it's difficult to predict which

kids will do well and which kids won't. Not only is it difficult to predict the course of

illness in some of these

kids, but the evidence for different treatment modalities for a diagnosis like bronchialitis,

for example, is all over the place, and I for one find it very confusing. The variation in

practice across Canada in management of bronchialitis is absolutely amazing.

Then there's the sphincter tightening really sick kid in severe respiratory distress who's tiring with altered LOC. We need to be confident in managing these kids with severe illness.

So, with the help of Dr. Dennis Skolnik, the Clinical Fellowship Program Director at Toronto's

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