Croup Flashcards
(8 cards)
- What is croup also known as?
- Which age group does it most commonly affect?
- What is the most common cause of croup?
- What time of year is it most common?
- What are the signs and symptoms?
- Laryngotracheobronchitis
- 6 months - 2 years old
- Parainfluenza virus
- Autumn/winter
- Coryzal symptoms, fever + cough for first 12-72 hours followed by barking cough, inspiratory stridor, hoarse voice.
Respiratory failure signs -> reduced air entry, cyanosis, tachycardia, accessory muscles
What is the most common bacterial cause of croup?
Mycoplasma pneumoniae
What findings on chest x ray indicate croup?
Steeple sign (tapering of upper trachea)
Investigations for croup
Clinical
CXR if wanting to rule out other pathology, e.g. foreign body aspiration
When would you admit a child with croup to hospital?
Stridor and/or sternal recession at rest
High fever
Respiratory rate > 60
Cyanosis
Lethargy or agitation
Fluid intake < 75% of normal or no wet nappies for 12 hours
Aged under 3 months
Chronic conditions such as immunodeficiency, chronic lung disease or neuromuscular disorders
Severity stages of croup?
Mild croup
Barking cough
Moderate croup
Barking cough, stridor, sternal recession at rest
Severe croup
Barking cough, stridor, sternal recession, intercostal recession
Impending respiratory failure
Minimal barking cough, stridor quieter, upper airway obstruction, recession, pallor, cyanosis, decreased consciousness, tachycardia, RR over 70
Management of croup?
**Mild croup: **
Single dose oral dexamethasone 0.15mg/kg, fluids, rest, analgesia for fever and pain
All other cases
Supplementary oxygen
Steroids - oral dexamethasone/prednisolone or if unable to swallow, nebulised budesonide
Nebulised adrenaline for temporary symptom relief
Complications of croup?
Dehydration secondary to poor fluid intake
Pneumonia due to secondary bacterial infection
Respiratory failure
Death - very rare (1 in every 30,000 cases)
