Question: A two-year-old child presents for elective surgery with a runny nose due to an upper respiratory tract infection (URTI). The child has no fever. What will you do and why?

Answer: Examine the child carefully and check the oxygen saturation. Children with URTI have more perioperative respiratory complications (e.g. laryngospasm, wheeze, postoperative infections). Consider postponing if:

• Child is 'unwell' and has a fever
• Chest signs – crackles, wheeze
• Oxygen saturation <94%
• Child is undergoing major surgery or surgery involving the airway
• Ideally postpone for 2-4 weeks if social situation allows a return at later date

Proceed if the child is well, with a runny nose only, and no fever.