Lightning Learning: Croup
STOP!
Croup is an upper airway disorder common amongst infants and children, with a peak incidence in age range 6 months to 3 years.
It typically presents with difficulty in breathing, an inspiratory stridor and “seal-like” barking cough and hoarse voice. Low grade pyrexia (up to 38.5°C) is also commonly seen.
Croup is often preceded by viral upper respiratory tract symptoms.
LOOK
Parainfluenza viruses are the most common cause of croup.
Airway symptoms are caused by inflammation at supraglottic, glottic, subglottic and tracheal level causing airway narrowing and turbulent airflow (stridor).
Key differentials include:
Epiglottitis
Bacterial tracheitis
Foreign body aspiration
LEARN
Croup management guideline (UHL) http://bit.ly/2u39ljP
Keep the child CALM. Most cases are mild and respond well to single dose steroid therapy. Oral Dexamethasone 0.15 mg/kg/dose.
Moderate/Severe Croup (biphasic stridor, irritability or reduced conscious level) may require nebulised adrenaline (0.4 ml/kg 1:1000, max 5 mls) and management in the ER.
