MBBS OSCE · Paediatrics
OSCE — Bronchiolitis
Eight-minute OSCE station on Bronchiolitis: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Bronchiolitis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Bronchiolitis is an acute viral lower respiratory tract infection of the small airways (bronchioles) in infants, typically under 2 years (peak 2 to 6 months), caused mainly by respiratory syncytial virus (RSV, 70 to 80 percent). Presentation: coryzal prodrome for 1 to 3 days, then worsening cough, wheeze, tachypnoea, and respiratory distress (nasal flaring, recession, grunting, head bobbing), with bilateral crackles and wheeze on auscultation. Most cases are mild and self-limiting. Treatment is supportive: oxygen if SpO2 persistently under 92 percent, nasal suctioning, and hydration (oral, NG, or IV). Bronchodilators, corticosteroids, antibiotics, chest physiotherapy, and routine imaging are
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Severe respiratory distress with marked recession, grunting, nasal flaring, head |
| Safety | Apnoea in an infant under 3 months (especially ex-preterm) - may be the presenti |
| Safety | SpO2 persistently under 92 percent in air despite supplemental oxygen - escalate |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.