D: Could you tell me what brought you in today? 

P: Sure um so my my son. He's 2 1/2 months old an were we're in the ER because he's had this cough, fever an seems like he's breathing too fast. It's been happening for the past two days and we weren't sure what else to do for him.

D: OK, uh, so the first thing here would be, uh, like vital signs and assessing kind of stability. So is there, do we have this information?

P: We're going to say vitals stable. He is on 2 litres of oxygen right now.

D: OK. So when did the symptoms specifically start?

P: Two days ago.

D: OK, and what started first?

P: Um so. I guess he was coughing first and then we took his temperature and it seemed like he had a fever. It was over 38 and then over the past couple of hours it seems like he's having a hard time breathing. He's breathing too fast. 

D: OK, so with this cough has there has there been any sputum come up?

P: Um yes yeah yellow sputum yeah

D: OK any blood that you notice in the sputum? 

P: No.

D: OK, uh and how was the fever checked?

P: We did, we did a rectal.

D: OK and it has the temperature uh, Like has it, has there been a fever the entire time?

P: We checked twice. We checked on the first day and then again last night. 

D: OK, um, and in regards to the difficulties breathing as there been any like changes to like is there been any noisy breathing?

P: I would say he sounds slightly wheezy. 

D: OK, have you been hearing any like whistling sounds when, when he's breathing in?

P: I wouldn't say whistling no, no.

D: OK. And has he been experiencing any other symptoms?

P: Um, no. He actually. He hasn't gone through as many wet diapers as he normally does.

D: OK, um has he been like, well, how's this appetite been?

P: Um not the greatest, no.

D: OK, so not not eating, eating as much or drinking as much? 

P: Yeah. 

D: OK. How has his behaviour been? 

P: He's been very, very fussy.

D: OK and inconsolable, would you say yes? 

P: Yeah.

D: OK, And any bowel problems?

P: No, not that we noticed.

D: OK, any vomiting?

P: No.

D: OK. And, uh, have you guys been around any anybody who's been sick? 

P: No. 

D: OK, so everybody else has been and been well, alright. Any travel recently?

P: We haven't traveled recently, um. My mom, so his grandma had traveled recently and he saw her last week.

D: OK. Where did she go?

P: Mexico.

D: OK, and how is Grandma doing now? 

P: She's doing fine, yeah.

D: OK. And, uh. And he saw her, he spent some time with her?

P: Mmhm, he spent the day with her.

D: OK, I see. And I. So in regards to a past health. Has he had any symptoms or like this before?

P: I guess last month he kinda had similar symptoms and they said it was a viral infection so he was just given some puffers to help his breathing and he got better on his own.

D: OK, did they tell you what the diagnosis was at that time, or just say that it was a viral infection?

P: No, they they said it could be bronchiolitis or just an upper viral infection. 

D: OK, um any reasons for hospitalizations?

P: At that time that he had the bronchiolitis or viral infection, he was hospitalized for two days just to help his breathing.

D: OK, um and. Any any medications that he takes regularly or uses regularly? 

P: Uh he, no no.

D: OK, any allergies to medications that you're aware of? 

P: No.

D: OK, and in regards to birth and prenatal history. Were there any complications throughout pregnancy?

P: No, I wouldn't say so, no, It was normal. Everything was normal and he was a healthy baby. 

D: OK. And has Mom had any complications with any prior pregnancies? 

P: No, he's he's the first one. He is the first one.

D: OK. And, uh, was mom well throughout the pregnancy, like no infectious symptoms during? 

P: No. No.

D:OK. Any concerns with his growth or development so far? 

P: No, he's been normal. 

D: OK, and then any concerns with either his vision or or hearing?

P: No. 

D: OK, so if you um. OK, And And are his immunizations up to date?

P: Uh, yes they are. 

D: OK, and, could you tell me a little bit about the living situation, uh who's in the home currently and where you guys are living?

P: Yeah, so we live in a house, it's him, myself, and my husband his dad. 

D: OK, any pets at home? 

P: No pets, No. Just, well actually a goldfish. 

D: Oh cool. And are there any concerns for like verbal abuse in the home?

P: No. 

D: How about any physical abuse in the home? 

P: No.

D: OK, and does anybody smoke cigarettes in the home? 

P: No.

D: OK, and then how about drink alcohol?

P: Mmm, we have like a glass of wine once a week.

D: OK, and who's the primary caregiver for him?

P: I guess we both are. Yeah, we both are. 

D: OK. And um in the family, are there any lung conditions like asthma or any heart conditions that run in the family?

P: Um, my sister. So his aunt has asthma.

D: OK, and Um. Does anybody, um is there any congenital diseases that run in the family? 

P: No, no. 

D: OK, How about any genetic diseases?

P: No. 

D: OK. And. So um it's sounding like, I wanted to do a work up for His symptoms right now for breathing heavily and with the fever that's concerning for a type of infection and with being under three months it would warrant some investigations. So we'd want to check, do some blood tests. Yeah, and check his cerebrospinal fluid as well to make sure that there's no infection um in the brain I guess and what kind of go go from there?

P: Sure, yeah, that sounds good.

D: OK, um in the meantime, yeah, we'll give him some inhalers and keep the oxygen on to help with the lungs and breathing and then keep monitoring for how he's doing symptomatically.

P: OK, thank you. 

D: You're welcome. Were there any, was there anything else that I I missed to ask about? 

P: Uh no, I don't think so. 

D: OK. Um, that sounds good. So if there was nothing else that you wanted to share, we will get that started and I I will be back shortly.

P: OK, sounds good, thank you.