On examination you find:
- Respiratory rate 45
- Marked increased Work of Breathing – there is nasal flaring, deep subcostal recession and tracheal tug, and “see-sawing” of the abdomen and chest wall
- There is obvious stridor
- Listening to the chest, there is no wheeze. There are some transmitted upper airway sounds, and slight crackles throughout
- Baby is not crying
- An occasional weak, dry cough
- Moving all 4 limbs and wriggling – baby is quite active
- Heart rate 190
- Baby is mottled and pale looking, central cap refill >5 seconds
- Temperature is 36.4 degrees Celsius
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Given the history and examination findings, is the most likely this an upper or a lower airway problem?
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