Mary aged 5 presents with her mother because she awoke during the evening with wheezing and breathing difficulty after a nocturnal cough for several days. She was a healthy baby but was given antibiotics for a respiratory infection with a slight wheeze, 12 months ago. There is no family history of respiratory problems but Mary has a past history of mild flexural eczema.

On examination she was anxious and had a barely audible wheeze.

Her vital signs were:
Temperature 37.5 C.
Pulse 114
Respiratory rate 28
BP 90/65

There was a slightly reddened throat and a clear nasal discharge.

Chest examination:
No deformity, No retraction, Percussion resonant, Generalised inspiratory and expiratory wheezes. No crackles or other abnormality including cyanosis.