“He’s got a cough and his breathing sounds noisy — is it just a cold?”

In a baby with bronchiolitis the remote consultation turns on a few questions: breathing effort (rate, recession, grunting), colour, feeding (under 50–75% of usual), wet nappies, alertness, and risk factors (under 3 months, prematurity especially under 32 weeks, chronic lung or significant heart disease, neuromuscular disease, immunodeficiency). Apnoea — observed OR reported — is a reason for immediate emergency referral even if the baby seems settled now; a reassuring voice on the phone does not cancel it. Parents rarely volunteer a pause in breathing, so ask directly. Home management (small frequent feeds, saline drops, paracetamol only for distress with fever, no antibiotics, salbutamol or steroids) is only right when red flags have been asked about and are absent, with clear safety-netting. Being honest about the limits of a telephone assessment and solving practical barriers (transport, siblings) are part of safe management.