A 2-year-old is brought to the emergency department at 2am with a barking cough and noisy breathing. How would you assess and manage this child?
- Croup: barking (seal-like) cough, inspiratory stridor, hoarseness; usually parainfluenza virus; peak age 2 years
- Symptoms worse at night and when child is agitated - avoid distressing examination
- Mild: no stridor at rest, mild recession -> oral dexamethasone 0.15mg/kg, consider discharge
- Moderate: stridor at rest, moderate recession -> oral dexamethasone, observe 1 - 2 hours
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How to approach this Paediatrics interview question
This clinical question is common in Paediatrics NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A 2-year-old is brought to the emergency department at 2am with a barking cough and..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.
What the panel is testing
A strong clinical answer sounds safe before it sounds clever. Use a structure such as initial assessment, immediate management, differential diagnosis, escalation, and reassessment. Mention guidelines only where they help the decision in front of you. For paediatrics, include the child, family, safeguarding context, and senior support early. Interviewers want safe clinical reasoning and family-centred communication.
- Start with immediate safety, ABCDE assessment, senior support, and escalation thresholds.
- Name the likely diagnoses or risks, but show how you would keep reassessing as new information arrives.
- Close with documentation, handover, follow-up, and patient or family communication where relevant.
How to structure your answer
For a clinical prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.
- Open by naming the main issue in the question.
- Give a structured response rather than a memorised script.
- End with escalation, documentation, learning, or follow-up.
Common mistakes to avoid
The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.
- Croup: barking (seal-like) cough, inspiratory stridor, hoarseness; usually parainfluenza virus; peak age 2 years
- Symptoms worse at night and when child is agitated - avoid distressing examination
- Mild: no stridor at rest, mild recession -> oral dexamethasone 0.15mg/kg, consider discharge