Child with cough and fast breathing — WHO pneumonia OSCE

Candidate instructions

Assess severity using WHO features and initiate treatment. Counsel the caregiver.

Candidate tasks

1. Count RR, look for indrawing and danger signs, measure SpO2.
2. Classify severe pneumonia.
3. Start oxygen and IV/IM antibiotics with doses.
4. Explain admission need and review plan.
5. Give vaccine/prevention counselling briefly.

Examiner checklist

• Uses age-specific fast-breathing threshold
• Identifies indrawing as severe
• Oxygen for hypoxia
• Ampicillin + gentamicin (or equivalent) doses
• Looks for danger signs of very severe disease
• Caregiver advice and safety-netting

Model standard

Severe pneumonia: admit, oxygen to SpO2 ≥90%, ampicillin 50 mg/kg q6h + gentamicin 7.5 mg/kg daily, supportive care, reassess 48 h, step down to oral amoxicillin when improving.

Common errors

• Home oral therapy despite indrawing/hypoxia
• Adult severity scores