A 4-year-old boy presented with an asthma attack secondary to an upper respiratory tract infection. He has an oxygen saturation of 90% and is tachycardic with a heart rate of 170 beats per minute. He has marked sternal recession, indrawing at the level of his diaphragm, and intercostal recession. He is tachypnoeic and has an expiratory wheeze. When he is sitting up recession is even more noticeable at the insertion of his diaphragm into his lower ribcage. There is suprasternal recession and wheeze is heard on auscultation.

This girl presented with a three-day illness with cough, pyrexia and tachypnoea due to a right lower lobe pneumonia. This is three days since antibiotic treatment commenced. She has reduced expansion on the right side and is also dull to percussion on the right. She has classical bronchial breathing over her right lower lobe associated with some inspiratory crackles. To test for vocal resonance, she was asked to say 99. As expected, this is transmitted much better to the stethoscope over the consolidated right lower lobe. To test for whispering pectoriloquy she was asked to whisper from 1 to 10 and keep repeating this. You can hear a dramatic difference between the two sides with the numbers heard over the right lower lobe.

This baby has a paroxysmal cough, and you can hear an inspiratory whoop. Whooping cough was suspected and confirmed by PCR. She appeared settled between paroxysms. She appears to have an apnoeic episode following coughing. As feeding triggered paroxysms she was on intravenous fluids.

This two-week-old boy developed severe RSV positive bronchiolitis requiring ventilation. He is orally intubated and has a nasogastric tube in situ. Inspiratory crepitations are heard particularly on the dependent left-hand side.