Shabna 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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