croup

Question 1

what is it and what are the symptoms

Answer 1

common childhood infection
causes barking cough and rasping sound when breathing

Question 2

does it need treatment?

Answer 2

usually mild but may need treatments
usually gets better on its own within 48 hours

Question 3

to ease discomfort, do the following

Answer 3

keep child upright and give plenty of fluids

Question 4

symtoms include (4) + initial presentation

Answer 4

barking cough
high pitches rasping sound when breathing in
hoarse voice
breathing difficulties

child will usually have cold like symptoms to begin with
croup symptoms follow after a few days
often worse at night

Question 5

looking after child with croup

Answer 5

• set child upright and try not to let them lie don
• comfort if distressed and try to keep them calm as crying can make symptoms worse
• plenty of fluids
• check on them regularly at night
• paracetamol or ibuprofen to help ease high temperature or any discomfort
• do not do steam inhalation - risk of scalding

Question 6

drug treatment for croup and dose

Answer 6

single dose of a CC (dexamethasone) may be of benefit
mild croup in child: 150mcg/kg for 1 dose

Question 7

Moderate to severe croup, or mild croup that might cause complications e.g. in those with chronic lung disease, immunodeficiency, impeding respiratory fissure, age under 3 months

Answer 7

Hospital admission needed
Administer single dose of CC e.g. dexamethasone or prednisolone by mouth while awaiting hospital admission
If child is too unwell to receive oral medication can give IM dexamethasone or budesonide by nebulisation while awaiting hospital admission

Question 8

Severe croup not effectively controlled with CC treatment

Answer 8

Nebulised adrenaline/epinephrine solution in 1 in 1000 (1 mg/mL) should be given with close clinical monitoring
Clinical effects of nebulised adrenaline last at least one hour but usually subside 2 hours after administration
Monitor child carefully for recurrence of severe respiratory distress