A 10-Year-Old Male with Acute Severe Asthma
Exacerbation: An i-Human Simulation Case
Study on Emergency Pediatric Respiratory
Management, Triage, Diagnosis, and
Treatment Planning.
i-Human Case Study: Pediatric Respiratory Emergency
Case Title: Acute Asthma Exacerbation in a 10-Year-Old Male
Patient Name: Lucas Bennett
Age: 10 years old
Gender: Male
Setting: Metropolitan General Hospital, Emergency Department
,Mode: Simulation (Guided / Assessed)
Chief Complaint: Difficulty breathing and wheezing.
Part 1: Case Introduction & Triage Note
Triage Note (Time: 14:30):
Patient Lucas Bennett, a 10-year-old male, arrives via personal car with
his mother. He is leaning forward in his chair, speaking in short phrases.
Audible wheeze noted at triage desk. Mother states symptoms began
this morning and have worsened over the past 2 hours despite using his
albuterol inhaler twice at home.
Initial Vital Signs (Triage):
• Heart Rate: 132 bpm
• Respiratory Rate: 38 breaths/min
• Temperature: 37.2°C (98.9°F)
• Blood Pressure: 108/72 mmHg
• SpO2 on Room Air: 91%
• Pain Scale: 4/10 (describes as chest tightness)
Immediate Action Ordered: Place patient in Room 4, start
supplemental oxygen via nasal cannula at 2L/min, and alert the
physician.
Part 2: Patient Encounter & History (H&P)
, You enter the room. Lucas is sitting on the edge of the bed, using his
accessory muscles. He gives a weak smile.
History of Present Illness (HPI):
Lucas is a known asthmatic diagnosed at age 5. Per his mother:
• Onset: Woke up this morning with a dry cough and mild shortness
of breath.
• Provoking Factors: Attended a birthday party at a friend's house
yesterday. Friend has a cat. Lucas is known to be allergic to cats
and dust mites. Weather has been chilly and damp for the past
two days.
• Timeline: Symptoms progressed throughout the school day
(teacher called mom). Mom picked him up at 13:00. Gave
albuterol MDI (90 mcg/puff) at 13:15 and again at 13:45 with
spacer. Minimal improvement noted.
• Severity: "He can't finish a sentence without stopping to breathe,"
reports mom. He is too breathless to run or play.
• Associated Symptoms: Non-productive cough, chest tightness,
fatigue. No fever, no vomiting.
Past Medical History (PMH):
• Diagnoses: Persistent Asthma (moderate severity).
• Allergies: Environmental (cats, dust mites, ragweed). NKDA.
• Medications:
o Maintenance: Fluticasone propionate 110 mcg, 2 puffs twice
daily. Last dose this morning.
Exacerbation: An i-Human Simulation Case
Study on Emergency Pediatric Respiratory
Management, Triage, Diagnosis, and
Treatment Planning.
i-Human Case Study: Pediatric Respiratory Emergency
Case Title: Acute Asthma Exacerbation in a 10-Year-Old Male
Patient Name: Lucas Bennett
Age: 10 years old
Gender: Male
Setting: Metropolitan General Hospital, Emergency Department
,Mode: Simulation (Guided / Assessed)
Chief Complaint: Difficulty breathing and wheezing.
Part 1: Case Introduction & Triage Note
Triage Note (Time: 14:30):
Patient Lucas Bennett, a 10-year-old male, arrives via personal car with
his mother. He is leaning forward in his chair, speaking in short phrases.
Audible wheeze noted at triage desk. Mother states symptoms began
this morning and have worsened over the past 2 hours despite using his
albuterol inhaler twice at home.
Initial Vital Signs (Triage):
• Heart Rate: 132 bpm
• Respiratory Rate: 38 breaths/min
• Temperature: 37.2°C (98.9°F)
• Blood Pressure: 108/72 mmHg
• SpO2 on Room Air: 91%
• Pain Scale: 4/10 (describes as chest tightness)
Immediate Action Ordered: Place patient in Room 4, start
supplemental oxygen via nasal cannula at 2L/min, and alert the
physician.
Part 2: Patient Encounter & History (H&P)
, You enter the room. Lucas is sitting on the edge of the bed, using his
accessory muscles. He gives a weak smile.
History of Present Illness (HPI):
Lucas is a known asthmatic diagnosed at age 5. Per his mother:
• Onset: Woke up this morning with a dry cough and mild shortness
of breath.
• Provoking Factors: Attended a birthday party at a friend's house
yesterday. Friend has a cat. Lucas is known to be allergic to cats
and dust mites. Weather has been chilly and damp for the past
two days.
• Timeline: Symptoms progressed throughout the school day
(teacher called mom). Mom picked him up at 13:00. Gave
albuterol MDI (90 mcg/puff) at 13:15 and again at 13:45 with
spacer. Minimal improvement noted.
• Severity: "He can't finish a sentence without stopping to breathe,"
reports mom. He is too breathless to run or play.
• Associated Symptoms: Non-productive cough, chest tightness,
fatigue. No fever, no vomiting.
Past Medical History (PMH):
• Diagnoses: Persistent Asthma (moderate severity).
• Allergies: Environmental (cats, dust mites, ragweed). NKDA.
• Medications:
o Maintenance: Fluticasone propionate 110 mcg, 2 puffs twice
daily. Last dose this morning.
