Croup childhood

Question 1

Croup

what about it

Answer 1

Common, acute respiratory illness

Gradual onset, typically mild and self-limiting

Most often seen in children aged 6/12 – 6 years

Occurs all year round
Peaks in spring & autumn
Often worse at night

Is the commonest cause of stridor

95% are due to viral illness

Parainfluenza virus most common cause, also RSV & influenza

Stridor, hoarseness, barking ‘seal like’ cough result from inflammation and narrowing around the subglottic region

Frightening experience for parents
Other causes for stridor: epiglottitis
Bacterial tacheitis, FB, abcesses, anaphylaxis etc.

Question 2

Signs & Symptoms

Viral croup

Answer 2

Onset over a few days
Preceding cold symptoms
Stridor only when upset
Stridor sounds harsh
Voice harsh
Barking cough
Unwell: temp < 38.5°C
Can swallow oral secretions

Question 3

Signs & Symptoms

Epiglottitis

Answer 3

Sudden onset
No preceding viral illness
Continuous stridor
Stridor softer (snoring)
Voice muffled / whispering
Cough not prominent
Toxic, very ill: temp 390C
Drooling of secretions

Question 4

Differences between the two – croup

Answer 4

Differences between the two – croup noisy
Epi – quieter, look more unwell, toxic
Epiglottitis not often seen in children now due to HIB immunisation. Good comparisom.

Question 5

coup Assessment

Answer 5

Hands off approach!
Observe:
Respiratory rate, grunting, recessions, colour, accessory muscle use, stridor
Engagability with carer: tiredness, agitation, drowsiness, lethargy, altered mental state
Oxygen saturations
Croup score

Question 6

tools for croup

Answer 6

Modified Taussig Croup Score

Question 7

croup Management child

Answer 7

Hands off, calm approach

Keep child in position of comfort

Avoid: examination of the throat, blood sugar measurement, nebulisers etc

Refer to appropriate facility for further treatment and management