Lesson 1Red flags and indications for urgent referral or ED evaluation: hypoxia, dehydration, severe respiratory distress, apneaIdentifies clinical red flags that require urgent referral or emergency evaluation, such as hypoxia, severe distress, apnea, dehydration, and altered mental status, and explains how to rapidly stabilise and arrange safe transfer when needed.
Recognising hypoxia and cyanosis promptlySevere work of breathing and exhaustionApnea, poor tone, and colour change eventsSigns of significant dehydration or shockHigh-risk groups needing lower thresholdsCoordinating safe transport and handoffLesson 2Communication with caregivers: explaining likely diagnosis, home care instructions, and safe escalation stepsCovers strategies for explaining diagnoses, expected illness course, and home care in plain language, while addressing caregiver anxiety, health literacy, and cultural factors, and outlining clear, concrete escalation and safety-net instructions.
Assessing caregiver understanding and concernsExplaining likely diagnosis in simple languageTeaching home care: fever, fluids, nasal careSetting clear, specific return precautionsShared decision-making and safety-nettingDocumenting key counselling points in the chartLesson 3Focused history for febrile cough in preschoolers: onset, fever pattern, respiratory distress signs, exposures, immunisation statusProvides a structured approach to history-taking for febrile cough in preschoolers, emphasising onset, fever pattern, respiratory distress signs, exposures, immunisation status, and risk factors that help distinguish benign from serious disease.
Characterising cough onset and durationFever pattern, height, and response to medsRespiratory distress symptoms at homeExposure history and sick contactsImmunisation status and risk modifiersPast medical history and prior episodesLesson 4Follow-up planning: return precautions, timeline for expected improvement, criteria for reassessmentExplains how to plan follow-up for acute respiratory illness, including expected timelines for symptom improvement, scheduling reassessment, reinforcing return precautions, and documenting plans that support continuity and caregiver confidence.
Expected recovery timelines by diagnosisWhen to schedule in-person follow-upPhone and telehealth check-in strategiesClear written return and ED precautionsDocumenting plans and caregiver agreementAddressing barriers to reliable follow-upLesson 5Reasoned use of diagnostics: when to order chest x-ray, rapid viral testing (RSV/flu), pulse oximetry, CBC, CRP, blood culturesOutlines when diagnostic tests change management in outpatient settings, including indications and limitations of chest x-ray, viral assays, pulse oximetry, and basic labs, while avoiding low-yield testing that increases cost or anxiety.
When chest x-ray meaningfully guides careRole of rapid RSV and influenza testingUsing pulse oximetry for triage decisionsWhen CBC or CRP may add valueRare indications for blood culturesCommunicating test limits to familiesLesson 6Antibiotic stewardship: criteria for suspecting bacterial pneumonia and first-line antibiotic choices by local guidelinesFocuses on recognising when bacterial pneumonia is likely, using history, exam, and risk factors, and choosing first-line outpatient antibiotics, doses, and durations that align with local resistance patterns and stewardship principles in Zimbabwe.
Clinical predictors of bacterial pneumoniaDistinguishing viral from bacterial patternsFirst-line oral antibiotics and dosingPenicillin allergy options and limitationsDuration of therapy and follow-up needsAvoiding unnecessary broad-spectrum agentsLesson 7Differential diagnoses: viral upper respiratory infection, bronchiolitis, community-acquired pneumonia, croup, pertussis—key distinguishing featuresReviews key clinical features that distinguish viral URI, bronchiolitis, pneumonia, croup, and pertussis in children, focusing on age, symptom patterns, exam findings, and red flags that suggest more serious lower airway disease.
Typical features of viral upper respiratory infectionClinical hallmarks of infant bronchiolitisCommunity-acquired pneumonia: signs by ageCroup: barking cough and stridor patternsPertussis stages and whooping cough cluesUsing patterns to separate overlapping syndromesLesson 8Initial outpatient management strategies: supportive care, antipyretics, hydration, inhaled bronchodilators—evidence-based indicationsDescribes evidence-based outpatient treatments for common respiratory illnesses, including antipyretics, nasal saline, hydration strategies, and bronchodilators, emphasising indications, dosing, and avoiding ineffective or harmful therapies.
Evidence-based fever and pain controlHydration strategies and oral rehydrationNasal saline, suction, and humidified airWhen to use inhaled bronchodilatorsAvoiding cough suppressants and decongestantsHome monitoring and positioning adviceLesson 9Targeted physical exam for respiratory illness: vital signs, respiratory rate by age, auscultation, work of breathing assessmentDetails a focused respiratory exam in children, including age-based vital sign interpretation, work of breathing scoring, auscultation techniques, and recognition of signs that suggest impending respiratory failure or need for escalation.
Age-based normal ranges for vital signsAssessing respiratory rate and rhythmWork of breathing: retractions and gruntingAuscultation: wheeze, crackles, stridorSigns of fatigue and impending failureIntegrating exam findings into triage level
