D: How can I help you today?

P: Hi um, I'm bringing my one year old daughter in because she's had this fever um, this runny nose and this cough, for the past three, four days. Um, and now, she sounds pretty wheezy.

D: Okay, and um, as she had a fever the entire time over the past three or four days.

P: Yeah, I would say so like it's come and gone, but every time I checked her temperature, I tried to check her twice a day, it would be pretty high, like 38 or uh, 39.

D: Okay, so it was between 38 and 39 each time you checked it.

P: Yeah, and now I should mention like um, I checked today and she didn't have a fever today, but she sounds really wheezy now.

D: Okay, is the wheeze new today? 

P: Uh yeah.

D: Okay, um, and the cough, that started about three or four days ago as well?

P: Yeah, that's right. 

D: And how, how does the cough sound? Does it sound like, barky or like a, seal-like cough?

P: Um, it sounds pretty harsh. I don't know if it sounds barky.

D: Okay, and is the cough worse at any particular time of the day, like morning or night?

P: Uh no it's, it's just always there.

D: Okay, uh, is she bringing up any, any phlegm or sputum?

P: Um, she's bringing up some, um, she's, she actually, she used to bring up some phlegm, but now it's, it's pretty dry.

D: Okay, um, so she was bringing up phlegm initially and is no longer. What colour was it?

P: It was clear.

D: Okay, any blood that you noticed there?

P: Uh, no, no blood.

D: Okay, um, and yeah, she's, she's had a wheeze as well. Um, have you noticed, uh, any chest pain, if she's like pointing to her chest or anything?

P: No, nothing like that.

D: Okay, and has she had any, any like fainting spells?

P: No. 

D: Okay. Um, and, yeah so she's had a fever, has she had any like, chills or night sweats, like where she's shaking?

P: Oh no, no. 

D: And how has her mood been?

P: She's been pretty fussy, um, yeah, she's been pretty fussy over the past few days, but I just thought it was because of how she was feeling um, like her symptoms.

D: Yeah, certainly. Has she been eating and drinking okay?

P: Yeah, we've managed to get her to drink and eat okay. Um, so, in that sense, no changes there.

D: Okay, how many diapers is she, how many wet diapers per day?

P: Uh, about five.

D: Okay, so yeah, still been to maintain hydration, it sounds like. Um, yeah, okay, and has she had any like, eye redness or eye discharge?

P: Uh no, nothing like that.

D: Any suggestion that she might have um, like any ear pain or, or any ear discharge?

P: No.

D: Okay, and has she had a runny nose?

P: Um yeah, now that you mention it, yeah, she did have a runny nose. Um, it seems to be less now, but she did have a lot a few days ago.

D: Okay, and did that start around the same time as the cough and, and fever?

P: Yeah.

D: Okay, um, it's still going on, but, but just less.

P: That's right, yeah. 

D: Okay. On feeds or anything like that, did you notice like any redness in her, in the back of her throat?

P: Um, I noticed some, um, yeah, I noticed some redness, but I just thought it was because of her coughing a lot.

D: Okay, um, and um, have you noticed any skin changes or, or rashes?

P: No. 

D: Alright, and any changes to bowel habits like diarrhea?

P: Uh no, no changes there.

D: Okay. Then any changes to um, like urinary habits as well?

P: Uh no, no changes there.

D: Okay, and have you noticed any like bulging on her, on her forehead or on the anterior fontanelle?

P: No.

D: Okay. Um, and uh, has she had any nausea or vomiting?

P: No, not that I've noticed.

D: Alright. Um just yeah, she's been a little bit more, um, irritable as well. Um, okay, and has she had any symptoms like this before?

P: I mean, when she was a few months old she had similar symptoms, um, and she was like hospitalized for maybe a day or two, but she became better.

D: Okay, did she need like antibiotics or inhalers or anything like that?

P: I think they just gave her some oxygen and then um, some fluids. 

D: Okay. Um, has she been diagnosed with any medical conditions before? 

P: No.

D: Okay, and besides that one time going, like going to the hospital, has she been hospitalized or had any surgeries?

P: Uh no, before that she was fine.

D: Alright, uh, are the immunizations up to date?

P: Yeah, everything's up to date. 

D: Excellent. Um, and in terms of the pregnancy itself, were there any complications throughout um, with mom?

P: Uh, no, no, no complications.

D: Okay. And was it a full term delivery, and vaginal or c-section?

P: It was uh, full time and it was vaginal.

D: Okay, any concerns at birth, like jaundice or, or any types of distress?

P: Uh no, nothing like that.

D: And how is her growth and development been thus far? Any concerns?

P: No. 

D: Okay, um, that's great, and in terms of um, the home environment, who's living with her and um, who's primarily looking after her?

P: Um, so it's her dad and I, as well as her um, her grandma.

D: Okay, and has anybody in the home been sick recently?

P: No, everyone's been healthy.

D: Okay, um, and has there been any travel?

P: Um no, we haven't gone anywhere recently.

D: Okay, um, and does anybody uh, in the house smoke?

P: Uh, nope. 

D: Okay, and are there, are there any pets or are there any like carpets or um, linens that can hold, hold a lot of dust or dander?

P: No. 

D: Okay, any other exposures, to like triggers, or potentially things that, that could be exposed or stuff like, that could be inhaled?

P: No, I don't have anything like that at home. It's a fairly new home and uh, it's hardwood floors, yeah.

D: Okay. Um, and uh, any family history of lung problems or heart problems?

P: No, no.

D: Okay, how about a family history of any congenital diseases or um, any genetic diseases?

P: No, nothing like that.

D: Okay, um, and family history of any cancer?

P: No. 

D: Okay. Um, so were there any other um, so that was everything that I wanted to ask today before I went on to the physical exam. Um, was there anything else that you, that you wanted to add or were wondering about that I maybe forgot to ask?

P: Yeah um, what, what can we do for her um, to make her better? And are you concerned about her breathing?

D: Um, so the, the physical exam and the, the vital signs will really, will help with um, to assess her breathing and to see oxygen levels.

P: Yeah.

D: Um, and um, this could be uh, caused by um, a viral infection, which could be something along the lines of uh, like a common cold type picture, and we can get like inflammation of uh, really small airways, um, and it can cause that cough, and fever, and some of the symptoms that she's experiencing. And also, um, these symptoms do overlap with COVID as well, um, and so it'll be important to get a COVID swab just in case. Um, but um, if that is the, the scenario, then it will be um, supportive care with oxygen, fluids and we'll make sure that um, that her, her breathing is uh, okay. And possibly, we'll need steroids and um, and uh, an inhaler if necessary. 

P: Okay. Okay, that sounds good, thank you.