Childhood emergencies

May 2010

FocusChildhood emergencies

Croup

Assessment and management

Volume 39, No.5, May 2010 Pages 280-282

Croup – assessment and managementShabna Rajapaksa MA, MB, BChir, MRCPCH, is a paediatric registrar, Emergency Department, Royal Children’s Hospital, M elbourne, Victoria.

Mike Starr MBBS, FRACP, is a paediatrician, infectious diseases physician, consultant in emergency medicine and Director, Paediatric Physician Training, Royal Children’s Hospital, Melbourne, Victoria.

Background

Croup is a common childhood disease characterised by sudden onset of a distinctive barking cough that is usually accompanied by stridor, hoarse voice, and respiratory distress resulting from upper airway obstruction. The introduction of steroids in the treatment of croup has seen a significant reduction in hospital admissions and improved outcomes for children.

Objective

This article discusses the key aspects of diagnosing croup and the evidence supporting the different treatment strategies.

Discussion

The assessment of airway, breathing and circulation, focusing on airway, is paramount in treating croup. However, it is important to take care not to cause the child undue distress. In mild to moderate croup, give prednisolone 1.0 mg/kg and review in 1 hour. In severe or life threatening croup, give 4 mL of adrenaline 1:1000 (undiluted) via nebuliser and send immediately to hospital via ambulance.

Croup, or laryngotracheobronchitis, is a common childhood upper airway disorder caused by a viral infection resulting in inflammation to the upper airway. This inflammation results in the classic symptoms of: barking cough, stridor, hoarse voice, and respiratory distress.1

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Correspondence afp@racgp.org.au

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