Lightning Learning: Croup
Croup is an upper airway disorder common amongst infants and children, with a peak incidence in age range 6 months to 3 years. They typically present with an initial incident of D.I.B. Parents describe child “struggling for breath”.
Inspiratory (Monophasic) Stridor and “seal/dog-like” barking cough and hoarse voice common symptoms. Low grade pyrexia (up to 38.5°C) also common.
Usually preceded by viral illness with coryzal type symptoms. Parainfluenza viruses are the commonest pathogens.
Airway symptoms are caused by inflammation at supraglottic, glottic, subglottic and tracheal level causing airway narrowing and turbulent airflow (Stridor).
The mechanism for this airway inflammation is not fully understood.
Keep the child CALM. Most cases are mild and respond well to single dose steroid therapy. Oral Dexamethasone 0.15mg/kg/dose.
Moderate/Severe Croup (biphasic stridor, irritability or reduced conscious level) may require nebulised adrenaline (0.4ml/kg 1:1000, max 5mls) and management in the ER.