Materiały źródłowe

• #1 Croup: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0501/p575.html

  Croup is a common respiratory illness affecting 3% of children six months to three years of age. […] Randomized controlled trials have demonstrated that a single dose of oral, intramuscular, or intravenous dexamethasone improves symptoms and reduces return visits and length of hospitalization in children with croup of any severity. […] In patients with moderate to severe croup, the addition of nebulized epinephrine improves symptoms and reduces length of hospitalization. […] Corticosteroids should be administered to patients with croup of any severity. […] Epinephrine should be administered to patients with moderate to severe croup. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Epinephrine decreases symptom scores in children with moderate or severe croup and should be given at the recommended dose of 0.05 mL per kg of racemic epinephrine 2.25% (maximum dose = 0.5 mL) or 0.5 mL per kg of L-epinephrine 1:1,000 via nebulizer (maximum dose = 5 mL).

• #1 Croup – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/croup/symptoms-causes/syc-20350348

  Croup most often occurs in younger children. It usually isn’t serious. Most children can be treated for croup at home. […] Contact your child’s health care provider if symptoms are severe, worsen, last longer than 3 to 5 days or aren’t responding to home treatment. […] Most cases of croup are mild. In a small number of children, the airway swells enough to cause problems with breathing. Rarely, a bacterial infection of the windpipe can occur in addition to the viral infection. This can result in trouble breathing and requires emergency medical care. […] To prevent croup, take the same steps you use to prevent colds and flu. Frequent hand-washing with soap and water for at least 20 seconds is the most important step. […] To prevent more-serious infections that may cause croup, keep your child’s vaccinations up to date. The diphtheria and Haemophilus influenzae type b (Hib) vaccines offer protection from some of the rarest but most dangerous upper airway infections.

• #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  CROUP TREATMENT […] The treatment of croup depends upon the severity of symptoms and the risk of rapid worsening. Children with mild symptoms who have no risk factors for developing severe croup generally are treated at home, while a child with moderate to severe symptoms or who is at risk for rapid worsening should be treated in an emergency department. Regardless of severity, it is important to keep the child calm since agitation and crying can worsen the symptoms. […] Mild croup — Most children with croup have mild symptoms (congestion and barking cough without stridor or respiratory distress). Children with mild croup are usually treated at home. […] Home management — Supportive care at home includes: […] Mist therapy or cool air — Mist therapy can be provided from a humidifier or sitting with the child in a bathroom (not in the shower) filled with steam generated by running hot water from the shower. Hot steam humidifiers should be avoided because of the risk of burns. A parent should stay with the child during mist treatment; a favorite book or lullaby may help to keep the child calm.

• #1 Croup – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/croup/diagnosis-treatment/drc-20350354

  Most children with croup can be treated at home. Still, croup can be scary, especially if your child needs a visit to the health care provider’s office, emergency room or hospital. Treatment is usually based on how severe the symptoms are. […] Your child’s health care provider may prescribe these medicines: […] A corticosteroid such as dexamethasone may be given to reduce swelling in the airway. Symptoms will usually start to improve within a few hours. […] Epinephrine is effective in reducing airway swelling with more-severe symptoms. […] For severe croup, your child may need to spend time in a hospital to be monitored and receive more treatments. […] Croup often runs its course within 3 to 5 days. […] In the meantime, keep your child comfortable with a few simple measures: […] For treatment of fever or pain, consider giving your child infants’ or children’s over-the-counter fever and pain medicines such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) as a safer alternative to aspirin. […] Your child’s cough may improve during the day, but don’t be surprised if it returns at night.

• #1

  https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Croup-Treatment.aspx?_gl=1*1qmilns*_ga*MTY0NTEyNzgxMS4xNzE0MTYxMDkz*_ga_FD9D3XZVQQ*MTcxNDE2MTA5My4xLjAuMTcxNDE2MTA5My4wLjAuMA..

  Croup is a common illness in young children. […] Read on for more information about croup, including types, causes, symptoms and treatments. […] If your child wakes up in the middle of the night with croup, try to keep them calm. Being upset and crying can worsen the cough and work of breathing. […] Treat it with acetaminophen or ibuprofen (for children older than 6 months), as needed. Make sure they are drinking fluids to avoid dehydration. […] In the past, parents may have been advised to try steam treatment in the bathroom. Though some parents may find that this helps improve breathing, there are no studies to prove that inhaling steam in a bathroom is effective. There are also no studies to prove that breathing in moist, cool night airs helps improve breathing. […] If your child has viral croup, your child’s doctor or the emergency department doctor may give them a breathing treatment with epinephrine (adrenaline) to decrease the swelling. After epinephrine is given, your child should be observed for 3 to 4 hours to confirm that croup symptoms do not return.

• #1 What is Croup? Symptoms, Treatment, and When to Worry | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/health-tip/what-is-croup-symptoms-treatment-and-when-to-worry

  Croup can present with more severe symptoms and breathing issues that dont resolve with simple home measures. If you have concerns about your childs breathing, you should bring them for medical evaluation right away. […] In most cases, a childs mild croup symptoms can be turned around with simple home remedies. […] Dr. Hughes suggests the following: Use a cool mist humidifier. Take the child into a steamed bathroom. Take the child outside into cool, moist, night air. Encourage the child to drink lots of fluids. Treat a fever with acetaminophen or ibuprofen, as instructed by your childs provider. Engage the child in a calming activity to keep them as quiet and calm as possible, which will make it easier for them to breathe. Stay in close proximity to the ill child at nighttime to immediately assist the child if they begin to have difficulty breathing.

• #1 Home Treatments for Croup that Will Help Your Child’s Barking Cough | University of Utah Health

  https://healthcare.utah.edu/the-scope/kids-zone/all/2023/01/home-treatments-croup-will-help-your-childs-barking-cough

  Croup Treatment at Home (Stridor) […] So how can you treat stridor? One of the best things to do when you’re at home is get the shower all steamed up and get your child in the bathroom, because warm, moist air seems to work best to relax the vocal cords and break the stridor. A humidifier, not a hot vaporizer, but a cool mist humidifier also will help with getting the swelling down. Cold air also helps relieve stridor. If it’s cold outside, take your child outdoors. If it’s not cold outside, you can actually hold your child in front of an open freezer door and have them take a few deep breaths in. […] If your child continues to have stridor, but it’s not completely blocking their airway, take them to the closest children’s emergency room. Your child may receive a dose of a steroid called dexamethasone, which helps shrink the swelling in your child’s airways. In severe cases, they may receive a breathing treatment of a medicine called racemic epinephrine that will actually help really quickly shrink the airway swelling down. Your child would then be admitted to the hospital for close observation overnight to make sure that the swelling doesn’t come back.

• #1 Croup Treatment & Management: Approach Considerations, Corticosteroids, Epinephrine

  https://emedicine.medscape.com/article/962972-treatment

  Urgent care or emergency department treatment of croup depends on the patient’s degree of respiratory distress. In mild croup, a child may present with only a croupy cough and may just require parental guidance and reassurance, given alertness, baseline minimal respiratory distress, proper oxygenation, and stable fluid status. Caregivers may only need education regarding the course of the disease and supportive homecare guidelines. […] Most children with mild croup symptoms can be successfully treated at home by their caregivers. Cool mist from a humidifier and/or sitting with the child in a bathroom (not in the shower) filled with steam generated by running hot water from the shower, help minimize symptoms. An adult caregiver should stay with the child during mist treatment. Engaging the child in a calming activity, such as reading a favorite book, can help decrease the child’s anxiety and minimize crying, which can worsen stridor. Other suggestions for home treatment of mild croup include:

• #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  Another option is to allow the child to breathe cool night air during by opening a window or door. […] Fever reduction — Fever can be treated with over-the-counter medications such as acetaminophen or ibuprofen. […] Encourage fluids — Warm, clear fluids may help to soothe the inflamed throat and vocal cords. Warm water or juice are safe for children older than four months. Frozen juice popsicles also can be given. […] Keep child’s head propped up — While sleeping, a child may be propped up in bed with an extra pillow. Pillows should not be used with infants younger than 12 months of age. […] Avoid smoke exposure — Smoking in the home should be avoided; smoke can worsen a child’s cough. […] Monitor for worsening symptoms — Parents/caregivers may sleep in the same room with their child during an episode of croup so that they will be immediately available if the child begins to have difficulty breathing.

• #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  If the child’s symptoms worsen (if they develop noisy breathing [stridor] that doesn’t improve with mist therapy, retractions [caving in of the skin and muscles between the ribs and below the ribcage], or rapid or labored breathing), the parent/caregiver should seek immediate medical attention. […] Management in the health care setting — A child with mild croup who is seen in a health care provider’s office or the emergency department is generally managed with the same supportive care measures that are used at home (mist therapy, medicines to reduce fever, encouraging fluid intake). In addition, the health care provider may give a single dose of a glucocorticoid medication. The most frequently used glucocorticoids are dexamethasone and prednisolone. These medications are usually administered as a liquid taken by mouth. Dexamethasone can also be given intravenously (IV) or with an intramuscular (IM) injection, especially if the child is vomiting and not able to keep liquids down. Less commonly, an inhaled glucocorticoid, budesonide, may be given if a child is unable to keep liquids down and does not have an IV.

• #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  Glucocorticoid medications such as dexamethasone, prednisolone, or budesonide work by decreasing inflammation in the airway. They typically start to work within four to six hours after the dose is given. For a child with mild croup, glucocorticoids may reduce the need for a repeat visit to the emergency department or provider’s office. […] Moderate to severe croup — Signs of moderate to severe croup include retractions (caving in of the skin and muscles between the ribs and below the ribcage), rapid or labored breathing, and stridor (noisy high-pitched breathing) that is heard even when the child is resting. […] Children with moderate to severe croup should be evaluated in an emergency department or clinic capable of managing urgent respiratory illnesses. Severe croup is a potentially life-threatening illness, and treatment should not be delayed for any reason.

• #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  The treatment of moderate to severe croup usually includes the following: […] Medications to reduce airway swelling — This includes a glucocorticoid medication (dexamethasone) and inhaled epinephrine. […] IV fluid therapy — This may be needed if the child is dehydrated as a result of fever or rapid breathing, both of which increase the body’s loss of fluids. Difficulty breathing can prevent a child from eating and drinking, which increases the risk of dehydration. […] Monitoring — This includes monitoring of oxygen levels, breathing, heart rate, and level of alertness, which are used to assess the child’s status and response to treatment. […] Oxygen therapy — If the child’s oxygen level is low, they will be given oxygen therapy. This is usually given by placing a tube (called a nasal cannula) under a child’s nose or by placing a face mask over the nose and mouth. For children with more severe symptoms, many hospitals use a form of oxygen therapy called „high flow.” High flow delivers oxygen at a high rate through a nasal cannula, which may help the infant breathe more comfortably. Placement of a breathing tube in the throat (called „intubation”) is rarely needed for children with severe croup; less than 1 percent of children seen in the emergency department for croup require intubation.

• #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  Mist therapy — Humidified air is sometimes used in the treatment of moderate to severe croup, although it is unclear whether it is beneficial. Mist therapy may provide a sense of comfort to the child. However, if the child is instead agitated by the mist, it is usually discontinued. […] Dexamethasone — Dexamethasone is the preferred glucocorticoid medication for treating moderate to severe croup. It is a long-acting medication that works by decreasing inflammation in the airway. It starts to work within four to six hours of the first dose. […] Dexamethasone has been shown to reduce signs of respiratory distress in children with croup. It also reduces the need for hospital admission and decreases the duration of the stay in the hospital. […] Dexamethasone can be given by mouth or as an IV or IM injection (depending upon which treatment is easiest for the child). Most children only require one dose. Serious side effects are rare.

• #1 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  Inhaled epinephrine — Inhaled epinephrine is given by nebulizer (an inhaled mist) to children with moderate to severe croup. It is a quick-acting medication that can rapidly reduce airway swelling. The effect is short-lived, lasting only two hours or less. Retreatment may be needed. […] The most common side effect of epinephrine is rapid heart rate. Serious side effects are rare. […] Children who are given epinephrine must be monitored for two to four hours after the last dose to ensure that their symptoms do not return. […] Other therapies — Other therapies, such as antibiotics, cough medicines, and decongestants are not routinely recommended for children with croup. Antibiotics do not play a role in treating croup because croup is caused by viruses and antibiotics do not treat viruses. Cough medicines and decongestants are generally not helpful and should not be used in children under the age of 6 years.

• #1 Croup Treatment & Management: Approach Considerations, Corticosteroids, Epinephrine

  https://emedicine.medscape.com/article/962972-treatment

  A randomized controlled trial by Siebert et al showed that exposure to cold outdoor air for 30 minutes reduced the severity of mild to moderate croup symptoms in children. […] Corticosteroids are beneficial due to their anti-inflammatory action. Their use decreases both laryngeal mucosal edema and the need for salvage nebulized epinephrine. […] A single dose of dexamethasone has been shown to be effective in reducing the overall severity of croup, if administered within the first 4-24 hours after the onset of illness. […] Nebulized racemic epinephrine is a 1:1 mixture of dextro (D) isomers and levo (L) isomers of epinephrine with the L form (L-epinephrine) as the active component. […] Heliox is a gas that contains a mixture of helium and oxygen (with not less than 20% oxygen). […] Several trials of heliox have demonstrated no advantage over conventional modalities; however, other trials have shown it to be equally effective in moderate to severe croup when compared with racemic epinephrine.

• #1 Croup

  https://www.rch.org.au/kidsinfo/fact_sheets/croup/

  Croup is a viral infection that narrows the airway, making breathing harder. […] The best way to care for a child with croup is to keep them calm and ensure they drink enough fluids. Doctors commonly prescribe steroids to reduce airway swelling. […] If your child has trouble breathing, you should see a doctor. They may prescribe steroids to help reduce airway swelling. Antibiotics will not help croup because it is caused by a virus. […] Steam is no longer recommended to treat croup. In the past, some doctors recommended mist or steam therapy for croup, including vaporisers. Scientific evidence now shows that these treatments do not help.

• #1 Croup In Children | KidsHealth New Zealand’s Trusted Voice On Children’s Health

  https://www.kidshealth.org.nz/croup

  Take your child to a health professional or the nearest hospital straight away if they: have stridor, have trouble breathing, are upset and you can’t calm them, you are worried for any other reason. […] Call 111 within New Zealand (use the appropriate emergency number in other countries) and ask for urgent medical help if your child has any of the following: is blue around the mouth, is struggling to breathe, is hard to wake, is floppy, is drooling.

• #1 Managing Recurrent Croup in Children | Children’s Hospital Colorado

  https://www.childrenscolorado.org/advances-answers/recent-articles/managing-recurrent-croup/

  Patients with recurrent croup may be referred to multiple disciplines for care, including pulmonology, otolaryngology, allergy and gastroenterology. […] In the largest retrospective study of its kind, our experts theorized recurrent croup is an airway reactivity issue similar to asthma not an anatomical problem that it could be treated with inhaled corticosteroids (ICS). […] Researchers tested and published compelling evidence supporting their hypothesis that initiating ICS at the onset of upper respiratory symptoms would safely improve symptoms. […] The initiation of ICS at the first sign of a viral upper respiratory infection to reduce episodes of recurrent croup is a novel preventative treatment developed by our experts. The team is planning to conduct randomized control trials in the future to validate its effectiveness.

• #1 Croup – Wikipedia

  https://en.wikipedia.org/wiki/Croup

  Croup can be caused by a number of viruses including parainfluenza and influenza virus. […] Most cases of croup are mild and the patient can be treated at home with supportive care. Croup is usually treated with a single dose of steroids by mouth. […] For children with moderate to severe croup, treatment with corticosteroids and nebulized epinephrine may be suggested. Steroids are given routinely, with epinephrine used in severe cases. […] Supportive care for children with croup includes resting and keeping the child hydrated. […] Corticosteroids, such as dexamethasone and budesonide, have been shown to improve outcomes in children with all severities of croup, however, the benefits may be delayed. […] Moderate to severe croup (for example, in the case of severe stridor) may be improved temporarily with nebulized epinephrine. […] More severe cases of croup may require treatment with oxygen. […] While other treatments for croup have been studied, none has sufficient evidence to support its use.

• #1

  https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Croup-Treatment.aspx?_gl=1*1qmilns*_ga*MTY0NTEyNzgxMS4xNzE0MTYxMDkz*_ga_FD9D3XZVQQ*MTcxNDE2MTA5My4xLjAuMTcxNDE2MTA5My4wLjAuMA..

• #2 Croup – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/croup

  Croup is acute inflammation of the upper and lower respiratory tracts most commonly caused by parainfluenza virus type 1 infection. […] Treatment is antipyretics, hydration, nebulized racemic epinephrine, and corticosteroids. […] For outpatients, cool humidified air and possibly a single dose of a long-acting corticosteroid. […] For inpatients, humidified oxygen, racemic epinephrine, and corticosteroids. […] High-dose dexamethasone 0.6 mg/kg IM or orally once (maximum dose 10 mg) may benefit children early in the first 24 hours of the disease. […] Nebulized racemic epinephrine offers symptomatic relief and relieves fatigue. However, the effects are transient; the course of the illness, the underlying viral infection, and the PaO2 are not altered by its use.

• #2 Croup - symptoms, causes and treatments | healthdirect

  https://www.healthdirect.gov.au/croup

  Croup is viral infection that causes swelling of the voice box (larynx) and the windpipe (trachea). […] There is no specific treatment for croup, but if breathing problems are severe, your child will need urgent medical attention. […] If your child has mild or moderate croup, they can usually be treated at home: Your doctor may prescribe a single dose of a steroid medicine. Give pain medicines, such as paracetamol, if your child has a fever or is irritable. Make sure your child is well hydrated. Keep your child calm if your child becomes distressed, their symptoms may worsen. […] If your child has severe croup, they should go to hospital immediately by ambulance. They may receive medicines such as adrenaline through a nebuliser and oral steroid medicines. They will then usually be monitored for at least 4 hours in the hospital. If their stridor improves, they may be discharged home. If your child’s symptoms get worse or do not get better, they may be admitted to hospital. […] Because croup is caused by a virus, antibiotics are not effective and are not recommended.

• #2 Croup: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/8277-croup

  Croup treatment depends on the severity of your childs condition and the risk of it rapidly worsening. […] You can usually treat mild croup at home. Home treatment includes using a cool mist humidifier to help soothe dry and irritated airways. […] For moderate to severe croup, you should take your child to the nearest urgent care center or emergency room (ER). Severe croup can be life-threatening, and you shouldnt delay taking your child in. Treatment for moderate to severe croup will vary based on your childs symptoms. Croup treatments may include: Humidified air or oxygen. IV fluids for dehydration. Monitoring of vital signs, including oxygen levels, breathing and heart rate. Croup medication, including steroids (glucocorticoids) and nebulized breathing treatments (epinephrine). […] If you take your child to their providers office or the emergency room, their provider will give them a glucocorticoid and a nebulized breathing treatment (epinephrine).

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7135

  Croup is an infection that causes swelling in the windpipe (trachea) and voice box (larynx). The swelling causes a loud, barking cough and sometimes makes breathing hard. Croup can be scary for you and your child, but it is rarely serious. In most cases, croup lasts from 2 to 5 days and can be treated at home. […] Sometimes a doctor will give medicine to decrease swelling. This medicine might be given as a shot or by mouth. Because croup is caused by a virus, antibiotics will not help your child get better. But children sometimes get an ear infection or other bacterial infection along with croup. Antibiotics may help in that case. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems.

• #2 Patient education: Croup in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

  Another option is to allow the child to breathe cool night air during by opening a window or door. […] Fever reduction — Fever can be treated with over-the-counter medications such as acetaminophen or ibuprofen. […] Encourage fluids — Warm, clear fluids may help to soothe the inflamed throat and vocal cords. Warm water or juice are safe for children older than four months. Frozen juice popsicles also can be given. […] Keep child’s head propped up — While sleeping, a child may be propped up in bed with an extra pillow. Pillows should not be used with infants younger than 12 months of age. […] Avoid smoke exposure — Smoking in the home should be avoided; smoke can worsen a child’s cough. […] Monitor for worsening symptoms — Parents/caregivers may sleep in the same room with their child during an episode of croup so that they will be immediately available if the child begins to have difficulty breathing.

• #2 Remedies for Croup: What to Do and When to See a Doctor

  https://www.webmd.com/children/remedies-croup

  Croup is an infection of the upper airway that makes it harder for babies and toddlers to breathe, along with causing a cough. […] Croup is usually not serious, but parents should trust their gut and call their doctor if they are concerned. If your child has trouble breathing, has a fever over 103.5 F, doesn’t want to drink, has stridor while resting, or has symptoms that don’t improve after 3-5 days, contact your doctor. […] The following remedies can be tried to keep your child comfortable until croup has passed, which typically takes three to five days: Keep your child as soothed and calm as possible. Read stories and cuddle. Try to avoid crying or running around, which will make breathing harder. Give extra liquids. Infants should drink breast milk or formula, while older children may have water, juices, soups, or ice pops. Avoid cough medicine, as it won’t help. Hold your child upright, which might make it easier to breathe. Use cool, humidified air or steam. Although there is no medical evidence that this improves symptoms, many parents find it helpful. Use a cool-mist humidifier, sit in the bathroom with the shower running hot to create steam, or take your child out into the cold night air for a few minutes while wrapped up to stay warm. Encourage rest and sleep.

• #2 Home Treatments for Croup that Will Help Your Child’s Barking Cough | University of Utah Health

  https://healthcare.utah.edu/the-scope/kids-zone/all/2023/01/home-treatments-croup-will-help-your-childs-barking-cough

  Croup Treatment at Home (Stridor) […] So how can you treat stridor? One of the best things to do when you’re at home is get the shower all steamed up and get your child in the bathroom, because warm, moist air seems to work best to relax the vocal cords and break the stridor. A humidifier, not a hot vaporizer, but a cool mist humidifier also will help with getting the swelling down. Cold air also helps relieve stridor. If it’s cold outside, take your child outdoors. If it’s not cold outside, you can actually hold your child in front of an open freezer door and have them take a few deep breaths in. […] If your child continues to have stridor, but it’s not completely blocking their airway, take them to the closest children’s emergency room. Your child may receive a dose of a steroid called dexamethasone, which helps shrink the swelling in your child’s airways. In severe cases, they may receive a breathing treatment of a medicine called racemic epinephrine that will actually help really quickly shrink the airway swelling down. Your child would then be admitted to the hospital for close observation overnight to make sure that the swelling doesn’t come back.

• #2 Croup – Diagnosis, Evaluation and Treatment

  https://www.radiologyinfo.org/en/info/croup

  Croup usually improves by itself. However, home treatments that introduce humidity or cold air into the environment are often used to help improve breathing. […] Home treatments focus on improving breathing by introducing humidity or cold air into the environment. You might run hot water in your shower with the bathroom door and windows closed and bring your child into the steamy room for 10 minutes. In cooler months, taking your child outside for a few minutes may ease symptoms. Running a cool air vaporizer in the child’s bedroom at night also can help improve breathing. […] Steroids and medicated sprays are sometimes used to reduce upper airway swelling in children with croup who do not respond to conservative management. […] In rare cases, pediatric patients affected with croup require hospitalization. Doctors will treat obstruction of the airway with steroids, inhaled adrenaline and oxygen. Rarely, intubation or the placement of a tube through the nose or mouth and into the main air passage to the lungs may be required. Intravenous fluids may be given if the child is dehydrated.

• #2 Home Treatments for Croup that Will Help Your Child’s Barking Cough | University of Utah Health

  https://healthcare.utah.edu/the-scope/kids-zone/all/2023/01/home-treatments-croup-will-help-your-childs-barking-cough

  So at home if your child is not too severe and you need to have them just managed at home, things you can do include: that humidifier, because dry air makes a cough worse, so the humidifier will help; warm fluids for the coughing spasms. […] Cough medicines are much less helpful than the mist or the warm fluids for croup, and children over 6 years old can be given cough drops for the cough, but children under the age of 4 should not be given any cough medications. […] If your child still has the croup, you can take them to your local pediatrician, and they can also be prescribed the steroid treatments that I mentioned when I talked about the emergency rooms. If your child is stable enough to be treated at home, the dexamethasone can be prescribed, and that medicine takes care of the barkiness of the croup cough, but the virus still needs to run its course, and the cough itself, not the barky part, but the cough that goes with the virus can last for up to three weeks.

• #2

  https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Croup-Treatment.aspx?_gl=1*1qmilns*_ga*MTY0NTEyNzgxMS4xNzE0MTYxMDkz*_ga_FD9D3XZVQQ*MTcxNDE2MTA5My4xLjAuMTcxNDE2MTA5My4wLjAuMA..

  Croup is a common illness in young children. […] Read on for more information about croup, including types, causes, symptoms and treatments. […] If your child wakes up in the middle of the night with croup, try to keep them calm. Being upset and crying can worsen the cough and work of breathing. […] Treat it with acetaminophen or ibuprofen (for children older than 6 months), as needed. Make sure they are drinking fluids to avoid dehydration. […] In the past, parents may have been advised to try steam treatment in the bathroom. Though some parents may find that this helps improve breathing, there are no studies to prove that inhaling steam in a bathroom is effective. There are also no studies to prove that breathing in moist, cool night airs helps improve breathing. […] If your child has viral croup, your child’s doctor or the emergency department doctor may give them a breathing treatment with epinephrine (adrenaline) to decrease the swelling. After epinephrine is given, your child should be observed for 3 to 4 hours to confirm that croup symptoms do not return.

• #2 What is Croup? Symptoms, Treatment, and When to Worry | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/health-tip/what-is-croup-symptoms-treatment-and-when-to-worry

  Croup can present with more severe symptoms and breathing issues that dont resolve with simple home measures. If you have concerns about your childs breathing, you should bring them for medical evaluation right away. […] In most cases, a childs mild croup symptoms can be turned around with simple home remedies. […] Dr. Hughes suggests the following: Use a cool mist humidifier. Take the child into a steamed bathroom. Take the child outside into cool, moist, night air. Encourage the child to drink lots of fluids. Treat a fever with acetaminophen or ibuprofen, as instructed by your childs provider. Engage the child in a calming activity to keep them as quiet and calm as possible, which will make it easier for them to breathe. Stay in close proximity to the ill child at nighttime to immediately assist the child if they begin to have difficulty breathing.

• #2 Croup: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0501/p575.html

  Croup is a common respiratory illness affecting 3% of children six months to three years of age. […] Randomized controlled trials have demonstrated that a single dose of oral, intramuscular, or intravenous dexamethasone improves symptoms and reduces return visits and length of hospitalization in children with croup of any severity. […] In patients with moderate to severe croup, the addition of nebulized epinephrine improves symptoms and reduces length of hospitalization. […] Corticosteroids should be administered to patients with croup of any severity. […] Epinephrine should be administered to patients with moderate to severe croup. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Epinephrine decreases symptom scores in children with moderate or severe croup and should be given at the recommended dose of 0.05 mL per kg of racemic epinephrine 2.25% (maximum dose = 0.5 mL) or 0.5 mL per kg of L-epinephrine 1:1,000 via nebulizer (maximum dose = 5 mL).

• #2 Croup (Laryngotracheobronchitis)

  https://www.rch.org.au/clinicalguide/guideline_index/croup_laryngotracheobronchitis/

  Children with barking cough alone and no history of stridor do not require steroids […] Consider oral steroids: dexamethasone 0.15 mg/kg oral or prednisolone 1 mg/kg oral if stridor present or if risk factors such as young age and ability to access urgent review […] Oral steroids: dexamethasone 0.15 mg/kg oral or prednisolone 1 mg/kg oral […] Consider nebulised adrenaline if persistent or worsening symptoms […] Senior clinician review. Manage in high acuity treatment area […] Nebulised adrenaline and […] Dexamethasone 0.6 mg/kg (max 12 mg) PO/IM/IV […] Move to resuscitation area and involve senior staff […] Nebulised adrenaline 5 mL of 1:1000 […] Dexamethasone 0.6 mg/kg (max 12 mg) IM/IV […] Antibiotics have no role in uncomplicated croup as it has a viral aetiology […] Anti-tussives such as codeine have no proven effect on the course or severity of croup, and may cause respiratory depression and increase sedation […] Cold air (below 10 C) exposure might reduce severity in moderate croup […] Humidified air has not been proven to change the severity of croup […] Heliox has not been shown to be better than nebulised adrenaline in severe croup.

• #2 Croup: diagnosis and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/croup-diagnosis-and-management

  Croup is a common childhood illness that can usually be managed at home. […] Pharmacists should be able to confidently recognise the symptoms and educate parents on management, including encouraging good oral fluid intake and administering antipyretics. […] Mild croup can generally be managed at home; however, hospital admission should be considered in certain circumstances, for example: […] The severity of the child’s condition will guide management of their condition. Mild croup can generally by managed at home. […] All children with croup (mild, moderate or severe) should receive a single dose of oral dexamethasone (0.15mg/kg). Improvement generally begins within 2–3 hours after a single oral dose of dexamethasone and benefit persists for 24–48 hours. […] If dexamethasone is not available, oral prednisolone 1mg/kg can be used instead.

• #2 Viral croup: diagnosis and a treatment algorithm – PubMed

  https://pubmed.ncbi.nlm.nih.gov/24596395/

  Viral croup is a frequent disease in early childhood. Although it is usually self-limited, it may occasionally become life-threatening. Mild croup is characterized by the presence of stridor without intercostal retractions, whereas moderate-to-severe croup is accompanied by increased work of breathing. A single dose of orally administered dexamethasone (0.15-0.6 mg/kg) is the mainstay of treatment with addition of nebulized epinephrine only in cases of moderate-to-severe croup. Nebulized budesonide (2 mg) can be given alternatively to children who do not tolerate oral dexamethasone. […] In summary, corticosteroids may decrease the intensity of viral croup symptoms irrespective to their severity on presentation to the emergency department.

• #2 Acute management of croup in the emergency department | Canadian Paediatric Society

  https://cps.ca/documents/position/acute-management-of-croup

  Croup is one of the most common causes of upper airway obstruction in young children. […] Published guidelines for the diagnosis and treatment of croup advise using steroids as the mainstay treatment for all children who present to emergency department (ED) with croup symptoms. Dexamethasone, given orally as a single dose at 0.6 mg/kg, is highly efficacious in treating croup symptoms. […] The clinical benefit of corticosteroids in croup is well established and should be considered for treating all children presenting with croup and symptoms ranging from mild to severe. Improvement generally begins within 2 to 3 hours after a single oral dose of dexamethasone and persists for 24 to 48 hours. […] Administering corticosteroids by the oral or intramuscular route is as efficacious or superior to the nebulized form of medication.

• #2 Croup – Diagnosis – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/respiratory/upper-respiratory-tract/croup/

  Croup, also known as acute laryngotracheitis or acute laryngotracheobronchitis, is a common viral childhood illness. It presents with a harsh barking cough and other clinical features including stridor, hoarseness of voice, and fever. […] In this article, we will discuss the epidemiology, pathophysiology, clinical features and management of croup. […] Most children with mild croup can be managed at home but consider admission in the following cases: Previous history of severe airway obstruction, 6 months of age, Immunocompromised, Have had inadequate fluid intake, Have had a poor response to initial treatment, The diagnosis is uncertain, There is significant parental anxiety. […] Advice to parents for home-managed patients should include: Explaining that the symptoms usually resolve within 48 hours but may last for up to a week. Explaining that croup is a viral illness and antibiotics are not needed. Paracetamol or ibuprofen can be used to control pain and fever. Ensure that the child has an adequate fluid intake. To seek urgent medical advice if symptoms worsen e.g. the development of intermittent stridor at rest or if the child starts to have a high fever and heart rate (this could indicate a different diagnosis such as bacterial tracheitis). To call an ambulance if the child starts to show signs of respiratory failure.

• #2 Croup (Laryngotracheobronchitis)

  https://www.rch.org.au/clinicalguide/guideline_index/croup_laryngotracheobronchitis/

  Croup is inflammation of the upper airway, larynx and trachea, usually triggered by a virus, most commonly parainfluenza as well as other respiratory viruses including COVID-19 (apply appropriate infection control) […] For severe and life-threatening croup, use nebulised adrenaline and seek a skilled senior clinician for airway support […] Less severe cases can be managed with corticosteroids alone […] Croup is a clinical diagnosis. Investigations such as respiratory swab or nasopharyngeal aspirate, X-rays and blood tests are not indicated in typical presentations. Consider appropriate investigations if there is concern for differential diagnoses as above […] Minimise distress to avoid worsening symptoms, minimise interventions including examination and investigation that are not going to impact acute management

• #2 Croup: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/8277-croup

  Glucocorticoids are a type of steroid that decreases the swelling of your childs voice box (larynx), typically within six hours of the first dose. […] Your child will receive epinephrine as an inhaled mist (nebulizer). This also reduces the swelling in your childs airways and usually starts working within 10 minutes. […] Serious side effects of epinephrine are rare. However, side effects could include a rapid heartbeat (tachycardia). […] Glucocorticoids usually start working within six hours of the first dose. Epinephrine typically begins working faster than glucocorticoids.

• #2 Croup | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/croup/

  Most cases of croup are mild and can be treated at home. […] Usually, your child will be prescribed medication to help reduce the swelling in their throat. The medication is a single dose of an oral corticosteroid called dexamethasone or prednisolone. Side effects of these medications can include restlessness, vomiting, upset stomach and headache. […] In severe cases of croup, treatment in hospital may be needed. This might include your child being given adrenaline or oxygen.

• #2 Croup: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000959.htm

  Your provider may prescribe medicines, such as: Steroid medicines taken by mouth or through an inhaler, Antibiotic medicine (for some, but not most cases). […] Your child may need to be treated in the emergency room or to stay in the hospital if they: Have breathing problems that do not go away or get worse, Become too tired because of breathing problems, Have bluish skin color, Are not drinking enough fluids. […] Medicines and treatments used at the hospital may include: Breathing medicines given with a nebulizer machine, Steroid medicines given through a vein (IV), An oxygen tent placed over a crib, Fluids given through a vein for dehydration, Antibiotics given through a vein. […] In some severe cases of croup that does not require emergency department care, a short course of oral glucocorticoids (steroids) may be useful to reduce swelling and improve symptoms. […] Rarely, a breathing tube through the nose or mouth will be needed to help your child breathe.

• #2 Croup – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/croup/

  Viral croup (i.e., acute laryngotracheobronchitis) is an inflammation of the upper airway that occurs in young children. […] All patients with viral croup should receive glucocorticoids (preferably dexamethasone) and supportive treatment. Patients with moderate or severe croup should also be evaluated for admission and receive nebulized racemic epinephrine and supplemental oxygen. […] Nebulized racemic epinephrine rapidly relieves symptoms of respiratory distress. Dexamethasone provides longer symptom relief but takes up to 6 hours to reduce airway swelling. […] Moderate croup/severe croup: Add nebulized epinephrine. […] Give dexamethasone (off-label). […] Start supportive care. […] Suspect other causes of stridor if there are no symptoms of an upper respiratory infection and if symptoms do not respond to treatments for croup.

• #2 Croup in Adults: Symptoms, Treatment, Outlook, and More

  https://www.healthline.com/health/croup-in-adults

  Croup is an infection that affects your breathing and causes a distinct barking cough. […] Read on to learn more about what causes croup and how doctors treat it. […] Adults with croup may need more aggressive treatment than children. […] Your doctor might prescribe a steroid, such as dexamethasone (DexPak) or epinephrine (nebulized that is, in the form of a mist) to lessen swelling in your airways. […] You might need to spend time in the hospital if your condition is severe. […] Studies show adults with croup typically stay in the hospital longer than children with croup. […] Sometimes doctors will need to place a breathing tube in your windpipe to help you breathe. […] Most kids start feeling better within three to five days, but adults might need more time to recover. […] If you develop croup as an adult, you might experience worse symptoms and need more aggressive treatment.

• #2 Croup: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0501/p1067.html

  Croup symptoms usually start like an upper respiratory tract infection, with low-grade fever and coryza followed by a barking cough and various degrees of respiratory distress. […] Humidification therapy has not been proven beneficial. A single dose of dexamethasone (0.15 to 0.60 mg per kg usually given orally) is recommended in all patients with croup, including those with mild disease. Nebulized epinephrine is an accepted treatment in patients with moderate to severe croup. […] Humidification therapy has long been used as a treatment for croup. However, it has not been shown to reduce croup severity, hospitalization, additional medical care, or epinephrine and corticosteroid use in patients with mild to moderate illness in the emergency department. […] Corticosteroid therapy benefits patients with croup presumably by decreasing edema in the laryngeal mucosa, and is usually effective within six hours of treatment. […] A number of small randomized controlled trials have shown that nebulized epinephrine is an effective treatment for moderate to severe croup, with benefits such as reduction in croup severity, various objective pathophysiologic measures, and need for intubation.

• #2

  https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Croup-Treatment.aspx?_gl=1*1qmilns*_ga*MTY0NTEyNzgxMS4xNzE0MTYxMDkz*_ga_FD9D3XZVQQ*MTcxNDE2MTA5My4xLjAuMTcxNDE2MTA5My4wLjAuMA..

  A steroid medicine may also be prescribed to reduce the swelling. Steroids can be inhaled, taken by mouth, or given by injection. Treatment with a few doses of steroids should do no harm. Steroids may decrease the intensity of symptoms, the need for other medications, and time spent in the hospital and emergency department. For spasmodic croup, your child’s doctor may recommend allergy or reflux medicines to help your child’s breathing. […] Antibiotics, which treat bacteria, are not helpful for treating croup because they are almost always caused by a virus or by allergy or reflux. Cough syrups are not useful and may do harm. […] Although most cases of croup are mild, this common childhood illness can become serious and prevent your child from breathing normally. Contact your child’s pediatrician if your child’s croup is not improving or if you have other concerns. The doctor will make sure your child is evaluated and treated properly.

• #2 Croup In Children | KidsHealth New Zealand’s Trusted Voice On Children’s Health

  https://www.kidshealth.org.nz/croup

  Croup is a viral illness in young tamariki, which causes narrowing of the upper airways. […] A health professional may prescribe a steroid medicine for croup. This reduces the swelling in your child’s airway and helps them to breathe more easily. It doesn’t change the cough but does reduce the stridor. Steroids work for about 48 hours. […] Antibiotics do not help tamariki with croup because it’s caused by a virus. […] If your child has croup, try to keep them calm and comfort them. Distress can make it harder for them to breathe and make the stridor worse. […] Adding steam to the air used to be recommended but there is no evidence it actually helps. There have been several cases reported where tamariki have been badly burned from the hot water. For these reasons, health professionals don’t recommend using steam for croup.

• #2 Croup – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/croup/symptoms-causes/syc-20350348

  Croup most often occurs in younger children. It usually isn’t serious. Most children can be treated for croup at home. […] Contact your child’s health care provider if symptoms are severe, worsen, last longer than 3 to 5 days or aren’t responding to home treatment. […] Most cases of croup are mild. In a small number of children, the airway swells enough to cause problems with breathing. Rarely, a bacterial infection of the windpipe can occur in addition to the viral infection. This can result in trouble breathing and requires emergency medical care. […] To prevent croup, take the same steps you use to prevent colds and flu. Frequent hand-washing with soap and water for at least 20 seconds is the most important step. […] To prevent more-serious infections that may cause croup, keep your child’s vaccinations up to date. The diphtheria and Haemophilus influenzae type b (Hib) vaccines offer protection from some of the rarest but most dangerous upper airway infections.

• #2 Croup

  https://www.seattlechildrens.org/conditions/a-z/croup/

  For fevers higher than 102 F (39 C), give an acetaminophen product (such as Tylenol). […] Your child can go back to school after the fever is gone. […] Most often, croup lasts 5 to 6 days and becomes worse at night. […] Call your doctor if trouble breathing occurs. […] Stridor (harsh raspy sound) occurs. […] Croupy cough lasts more than 14 days.

• #2 Croup (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/croup.html

  Most cases of croup are mild and can be treated at home. Try to keep your child calm, as crying can make croup worse. […] Some kids need a breathing treatment that can be given in the hospital or a steroid medicine to reduce swelling in the airway. Rarely, kids with croup might need to stay in a hospital until they’re breathing better.

• #2 Croup – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/681

  Croup is a common cause of acute respiratory distress in children. […] Orally administered corticosteroids are the mainstay for all levels of severity, combined with nebulised epinephrine (adrenaline) in moderate to severe croup to provide temporary relief of the symptoms of upper-airway obstruction. […] Treatment algorithm.

• #2 Croup: Symptoms, Causes, Treatment

  https://resources.healthgrades.com/right-care/lungs-breathing-and-respiration/croup

  Croup usually goes away on its own within 1 week, perhaps with over-the-counter medications for comfort. […] Care tips include: acetaminophen (Tylenol) for fever and mild pain, ibuprofen (Advil, Motrin) for fever and mild pain, in children 6 months and older, not treating croup with cough medicines unless your child’s healthcare practitioner directs you, fluids. […] A common at-home treatment to calm breathing is to place the child in a steamy bathroom, place a humidifier or vaporizer in the child’s room, or bring the child outside if the air is cool. The AAP explains there are no studies showing this is effective for croup. […] More severe croup may require care and supplemental oxygen in a hospital. Medication options may include steroid therapy, such as prednisolone (Pediapred) or dexamethasone (Baycadron), to reduce inflammation and swelling. Nebulized epinephrine may also ease breathing. […] Yes, croup goes away on its own in many cases. Medications and supplemental oxygen may be necessary for severe croup. They do not clear the infection, but they do reduce swelling and improve breathing.

• #3 Croup (Laryngotracheobronchitis)

  https://www.rch.org.au/clinicalguide/guideline_index/croup_laryngotracheobronchitis/

  Croup is inflammation of the upper airway, larynx and trachea, usually triggered by a virus, most commonly parainfluenza as well as other respiratory viruses including COVID-19 (apply appropriate infection control) […] For severe and life-threatening croup, use nebulised adrenaline and seek a skilled senior clinician for airway support […] Less severe cases can be managed with corticosteroids alone […] Croup is a clinical diagnosis. Investigations such as respiratory swab or nasopharyngeal aspirate, X-rays and blood tests are not indicated in typical presentations. Consider appropriate investigations if there is concern for differential diagnoses as above […] Minimise distress to avoid worsening symptoms, minimise interventions including examination and investigation that are not going to impact acute management

• #3 Croup - symptoms, causes and treatments | healthdirect

  https://www.healthdirect.gov.au/croup

  Croup is viral infection that causes swelling of the voice box (larynx) and the windpipe (trachea). […] There is no specific treatment for croup, but if breathing problems are severe, your child will need urgent medical attention. […] If your child has mild or moderate croup, they can usually be treated at home: Your doctor may prescribe a single dose of a steroid medicine. Give pain medicines, such as paracetamol, if your child has a fever or is irritable. Make sure your child is well hydrated. Keep your child calm if your child becomes distressed, their symptoms may worsen. […] If your child has severe croup, they should go to hospital immediately by ambulance. They may receive medicines such as adrenaline through a nebuliser and oral steroid medicines. They will then usually be monitored for at least 4 hours in the hospital. If their stridor improves, they may be discharged home. If your child’s symptoms get worse or do not get better, they may be admitted to hospital. […] Because croup is caused by a virus, antibiotics are not effective and are not recommended.

• #3 Croup: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0501/p575.html

  Croup is a common respiratory illness affecting 3% of children six months to three years of age. […] Randomized controlled trials have demonstrated that a single dose of oral, intramuscular, or intravenous dexamethasone improves symptoms and reduces return visits and length of hospitalization in children with croup of any severity. […] In patients with moderate to severe croup, the addition of nebulized epinephrine improves symptoms and reduces length of hospitalization. […] Corticosteroids should be administered to patients with croup of any severity. […] Epinephrine should be administered to patients with moderate to severe croup. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Epinephrine decreases symptom scores in children with moderate or severe croup and should be given at the recommended dose of 0.05 mL per kg of racemic epinephrine 2.25% (maximum dose = 0.5 mL) or 0.5 mL per kg of L-epinephrine 1:1,000 via nebulizer (maximum dose = 5 mL).

• #3 Croup – Diagnosis – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/respiratory/upper-respiratory-tract/croup/

  Immediate hospital admission should occur if: The child has moderate/severe croup or impending respiratory failure. You suspect a serious disorder caused by infection e.g. peritonsillar abscess, laryngeal diphtheria, or a non-infectious cause e.g. foreign body, angioneurotic oedema. […] For all children with croup give a single dose of oral dexamethasone (0.15mg/kg body weight) or oral prednisolone (1-2mg/kg body weight). […] Nebulised adrenaline can be given to provide temporary relief of symptoms. […] Ensure the child is kept as calm as possible as continuing crying increases oxygen demand causes respiratory muscle fatigue. […] Humidified air/steam inhalation is not advised. […] Oxygen Therapy as required. […] Contact ENT and an anaesthetist if there is need for airway support.

• #3 Croup-like illness | Paediatric ECAT protocol | Emergency care assessment and treatment

  https://aci.health.nsw.gov.au/ecat/paediatric/croup-like-illness

  If the patient has any Yellow or Red Zone observations or additional criteria (as per the relevant NSW Standard Emergency Observation Chart), refer and escalate as per local CERS protocol and continue treatment. […] Immediately escalate as per local CERS protocol. […] Give nebulised adrenaline (epinephrine) 5 mg (equivalent to 5 mL or 5 ampoules of 1:1000) undiluted, with 810 L of oxygen via nebuliser. Repeat nebulised adrenaline dose every 15 minutes until improvement or airway support obtained. […] Give dexamethasone 0.15 mg/kg orally once only, maximum dose 12 mg […] or give prednisolone 1 mg/kg orally once only, maximum dose 50 mg […] or if oral corticosteroid is not tolerated, give nebulised budesonide 2 mg once only. […] Less severe cases can be managed with corticosteroids alone. […] Repeat and document assessment and observations to monitor responses to interventions, identify developing trends and clinical deterioration. Escalate care as required according to the local CERS protocol.

• #3 Croup: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/8277-croup

  Glucocorticoids are a type of steroid that decreases the swelling of your childs voice box (larynx), typically within six hours of the first dose. […] Your child will receive epinephrine as an inhaled mist (nebulizer). This also reduces the swelling in your childs airways and usually starts working within 10 minutes. […] Serious side effects of epinephrine are rare. However, side effects could include a rapid heartbeat (tachycardia). […] Glucocorticoids usually start working within six hours of the first dose. Epinephrine typically begins working faster than glucocorticoids.

• #3 Acute management of croup in the emergency department | Canadian Paediatric Society

  https://cps.ca/documents/position/acute-management-of-croup

  Overall, children treated with corticosteroids have fewer return visits or admissions to the hospital. […] Nebulized epinephrine is recommended for moderate to severe croup. […] A heliox or helium-oxygen mixture can reduce respiratory distress in children with severe croup. […] The use of antibiotics and short-acting beta-2-agonist bronchodilators in children with typical croup are rarely indicated because of the low incidence of bacterial infection.

• #3 Croup Treatment | National Jewish Health

  https://www.nationaljewish.org/conditions/croup/treatment

  In most cases, croup can be treated at home. […] Treatment with cool mist may help symptoms. Cool mist therapy may be delivered by placing a vaporizer or humidifier in the childs bedroom. […] In addition to cool mist therapy, the child should receive adequate rest and drink plenty of fluids. […] There are a number of medicines that may be used when a child is seen in the doctors office or hospital. […] Corticosteroids can decrease swelling in the throat and windpipe to improve symptoms of croup. […] Racemic epinephrine can also decrease swelling briefly. […] Antibiotics may not be used, because croup is often a viral infection. […] In addition to medicines, your child can be monitored closely in the doctor’s office or the hospital. […] The HIB vaccine is given routinely. This vaccine is helpful in preventing a number of illnesses.

• #3 Croup Cough, Symptoms, Treatment, Contagious, Virus

  https://www.medicinenet.com/croup/article.htm

  The American Academy of Pediatrics recommends avoiding most combination cough and cold medicines. Several studies show that these medicines are ineffective in children. They can potentially cause side effects that could lead to more serious symptoms. Acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) are helpful for pain relief and fever. […] Occasionally, an oral cortisone medication (dexamethasone) is prescribed for more severe cases of croup. […] Rarely, a patient may have severe respiratory symptoms that need treatment with inhalation therapy with epinephrine (adrenaline) in the hospital where he or she can be monitored continuously. These therapies provide a temporary (two-hour) reduction of symptoms but are commonly followed by a return of equally severe symptoms. This reappearance of symptoms is commonly termed a „rebound” phenomenon. […] Because a virus usually causes croup, antibiotics are reserved for those rare occasions when bacterial infections cause croup or become superimposed on the viral infection.

• #4 Treatment of croup. Sending home an improved child and relieved parents – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9074564/

  Croup is the most common cause of upper airway obstruction in children between the ages of 6 months and 6 years. Most children can be effectively treated in the office or emergency department with nebulized saline solution and oral or intramuscular dexamethasone (Decadron, Hexadrol) in a dose of 0.6 mg/kg. […] Occasionally, nebulized racemic epinephrine must be given; a dose of 0.5 mL of 2.25% solution diluted in 2.5 mL of saline solution is safe for all ages. Children requiring two epinephrine treatments should be hospitalized. Home care consists of adequate hydration and humidification and fever control. Antihistamines, decongestants, and antibiotics have no proven effect on uncomplicated viral croup.

Zobacz więcej