Croup
Croup is the most common cause of upper airway obstruction in children. It is characterized by acute onset of barky cough +/- stridor. The typical age of presentation is between 6 months and 5 years with a peak around 2 years. Consider other causes of upper airway obstruction such as bacterial tracheitis, epiglottitis and retropharyngeal abscess in children presenting with severe symptoms and a transient or lack of response to croup treatment.
- X-rays are rarely necessary to confirm the diagnosis of croup.
- Symptoms are triggered by a viral infection, antibiotics are not effective.
- A single dose of dexamethasone 0.15 to 0.6 mg/kg (MAX 12 mg/dose) PO should be given to ALL children who present to the emergency department with croup.
- Minimize interaction and place the child in a position of comfort (e.g., caregiver’s lap), as agitation can precipitate significant respiratory distress.