This chapter looks at clinical symptoms that require prompt attention from the doctor. Common symptoms discussed include acute stridor, acute wheeze, transient loss of consciousness, anaphylaxis and coma, which incorporates treatment of shock, sepsis, diabetic ketoacidosis, bacterial meningitis and status epilepticus. Each symptom is described, the potential differential diagnosis is provided, potentially useful assessment tools outlined and management steps indicated. A key element in dealing with emergencies is ensuring treatments are given in a timely fashion; therefore, keep an eye on the clock, the patient is depending on you. The scoring systems, in general, do not have strong evidence; however, for the trainee they offer a strategy to assess the child and determine the impact of treatment. The Preschool Respiratory Assessment Measure is an indicator of asthma severity. It is useful for the preschool population and a change in score of 3 is clinically relevant.