Croup Medical Directive

Question 1

What are the indications?

Answer 1

• Current hx of URTI AND barking cough or recent hx of a barking cough

Question 2

What are the two medications for croup medical directive?

Answer 2

• Epinephrine & dexamethasone

Question 3

What are the conditions of epinephrine?

Answer 3

• Age= > 6 months to <8 yrs
• HR= <200 bpm
• Other: stridor @ rest

Question 4

What are the conditions for dexamethasone?

Answer 4

• Age= > 6 months to <8 yrs
• LOA= unaltered
• Other: for mild, moderate and severe croup

Question 5

What are the contraindications for epinephrine?

Answer 5

• Allergy or sensitivity to epinephrine

Question 6

What are the contraindications for dexamethasone?

Answer 6

• Allergy or sensitivity to steroids
• Steroids received within the last 48 hours
• Unable to tolerate oral medications

Question 7

What is the treatment for epinephrine? (Weight= <10 kg)

Answer 7

• Route= NEB
• Concentration= 1:1000
• Dose= 2.5mg
• Max. single dose= 2.5mg
• Dosing interval= n/a
• Max. # of doses= 1

Question 8

What is the treatment for epinephrine? (Weight= >10 kg)

Answer 8

• Route= NEB
• Concentration= 1:1000
• Dose= 5 mg
• Max. single dose= 5 mg
• Dosing interval= n/a
• Max. # of doses= 1

Question 9

What is the treatment for dexamethasone?

Answer 9

• Age= >6 months to <8 yrs
• Route= PO
• Dose= 0.5mg/kg
• Max. single dose= 8 mg
• Dosing interval= n/a
• Max. # of doses= 1