A 7-year-old known asthmatic presents with worsening wheeze, breathlessness, and difficulty speaking in full sentences. How would you classify the severity and manage this child?
- Severity classification in children >2 years: \begin{itemize}[nosep]
- Moderate: SpO2 $\geq$92%, PEF $\geq$50%, no life-threatening features
- Severe: SpO2 <92%, PEF 33 - 50%, cannot complete sentences, too breathless to feed, HR >125 (5 - 12 years)
- Life-threatening: SpO2 <92%, PEF <33%, silent chest, cyanosis, poor respiratory effort, hypotension, confusion/exhaustion
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How to approach this Paediatrics interview question
This quality improvement 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 7-year-old known asthmatic presents with worsening wheeze, breathlessness, 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 quality-improvement answer uses method as well as enthusiasm. Be clear about the problem, baseline measurement, intervention, re-measurement, and how the change was made sustainable. For paediatrics, include the child, family, safeguarding context, and senior support early. Interviewers want safe clinical reasoning and family-centred communication.
- Separate audit, QI, research, and clinical governance clearly so the panel can follow your reasoning.
- Use a real cycle: baseline, intervention, re-measurement, learning, and sustainability.
- Link the project back to patient safety, service reliability, or measurable outcomes.
How to structure your answer
For a quality improvement 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.
- Severity classification in children >2 years: \begin{itemize}[nosep]
- Moderate: SpO2 $\geq$92%, PEF $\geq$50%, no life-threatening features
- Severe: SpO2 <92%, PEF 33 - 50%, cannot complete sentences, too breathless to feed, HR >125 (5 - 12 years)