Materiały źródłowe

• #1 Croup – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431070/

  Croup is a common respiratory illness of the trachea, larynx, and bronchi that can lead to inspiratory stridor and barking cough. […] Corticosteroids should be administered to all patients with croup, and epinephrine is reserved in those with moderate to severe croup. […] Treatment depends on the severity based on the Westley croup score. Children with mild croup defined as Westley croup score less than 2 are given a single dose dexamethasone. Children with moderate to severe croup defined as a Westley croup score greater than 3 are given nebulized epinephrine in addition to dexamethasone. […] Corticosteroids, such as dexamethasone, results in faster resolution of symptoms, decreased return to medical care, and decreased length of stay. […] Croup is most commonly a viral disease. Antibiotics are reserved for cases when primary or secondary bacterial infection is suspected.

• #1 Croup vaccine, treatments, home remedies, and prevention

  https://www.medicalnewstoday.com/articles/croup-vaccine

  Croup is difficult to prevent, but it may be possible to decrease a childs chances of contracting croup. […] Although no vaccine is available, good hygiene practices can reduce the risk of transmitting HPIVs. These practices may include: washing the hands often with soap and water, which is especially important during child care; avoiding physical contact with the eyes, nose, and mouth; avoiding close contact with other people during periods of sickness; wearing a face mask, which may help prevent transmission of HPIVs. […] Breastfeeding or chestfeeding may also reduce a babys risk of developing croup. Breast milk contains vital proteins that help a babys body defend itself against infections. […] Vaccination for influenza and diphtheria may reduce the number of children who get croup. […] Good hygiene practices and breastfeeding or chestfeeding may help people reduce a childs chances of developing croup.

• #1 Croup: Causes, Symptoms & Treatment

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

  Croup can spread by physical contact or through the air. To help prevent its spread: […] Wash and dry your hands thoroughly after caring for your child. […] Wash toys between each use. […] Encourage your child to cover their mouth and nose when coughing and sneezing. […] Keep your child home from school or daycare when they’re ill or if outbreaks occur. […] Throw used tissues away.

• #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/print

  CROUP PREVENTION […] Simple hygiene measures can help to prevent infection with the viruses that lead to croup. […] Hygiene and other preventive measures include: […] Frequently wash hands with soap and water – Hands should ideally be wet with water and plain or antimicrobial soap and rubbed together for 15 to 30 seconds. Special attention should be paid to the fingernails, between the fingers, and the wrists. Hands should be rinsed thoroughly and dried with a single-use towel. […] Use alcohol-based hand rubs – These are a good alternative for disinfecting hands if a sink is not available. Hand rubs should be spread over the entire surface of hands, fingers, and wrists until dry and may be used several times. Hand rubs are available as a liquid or wipe in small, portable sizes that are easy to carry in a pocket or handbag. When a sink is available, visibly soiled hands should be washed with soap and water.

• #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/print

  Avoid close contact with other adults and children with upper respiratory infection when possible – This may be difficult, especially when in public, but parents/caregivers can try to limit direct contact. In addition, infants or children who are sick should not be sent to daycare or school, as this can spread the illness to others. […] Ensure the child is vaccinated – There are no vaccines against the most common virus that cause croup (parainfluenza virus). However, vaccines are recommended for other viruses that can cause croup (influenza, COVID-19, and measles).

• #1 Croup – Symptoms & causes – Mayo Clinic

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

  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. […] Keep your child away from anyone who’s sick. […] Encourage your child to cough or sneeze into the elbow. […] Clean frequently touched surfaces. […] 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. There isn’t a vaccine yet that protects against parainfluenza viruses.

• #1 Is Croup Contagious? Causes, Symptoms, and Prevention

  https://www.volusiamedicalcenter.net/post/is-croup-contagious-causes-symptoms-and-prevention

  Croup is a contagious illness that affects young kids, leading to a barking cough and trouble breathing. […] To stop croup from spreading, practice good hand washing and keep up with vaccinations. By doing this, you can help keep your child healthy and safe. […] Washing your hands regularly with soap and water can help prevent the spread of viruses that cause croup. […] Keep children away from people with respiratory infections, especially if they are coughing or have a fever. […] Cleaning and disinfecting frequently touched objects like toys, doorknobs, and countertops can help reduce the risk of infection. […] Teaching children to cough or sneeze into their elbow or a tissue can help prevent the spread of germs. […] Eating well, sleeping enough, and exercising regularly can make your immune system stronger. […] There isn’t a vaccine that stops croup directly, but vaccines for the flu and other respiratory illnesses can reduce the risk. […] Using a cool-mist humidifier can help keep the air wet and make it easier to breathe.

• #1 Croup | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/croup

  Croup is a viral infection of the throat and windpipe that causes noisy breathing, a hoarse voice and a harsh, barking cough. […] You can treat mild croup at home if your child has no breathing problems or noisy breathing when they are not crying. […] The viruses that cause croup are very similar to those of the common cold. They start to be infectious with the first signs, such as a runny nose and cough, and remain infectious for up to 5 days. Only about one in 10 children who get these viruses will develop croup. […] It is important to practice good hygiene by washing hands, coughing and sneezing into the elbow and staying home when unwell. […] It is not usually possible to prevent croup. Many viruses can cause it and there is no immunisation available against most of them. However, immunisation against influenza is recommended as this may actually prevent croup caused by the influenza virus (influenza-induced croup). […] All children who are aged 6 months and older can be immunised against influenza. This is especially important for children with an underlying chronic illness such as asthma or cystic fibrosis. […] Antibiotics will not be of use as the viruses that cause croup will not respond to this treatment.

• #1 Croup – Wikipedia

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

  Many cases of croup are preventable by immunization for influenza and diphtheria.[5] […] Croup is contagious during the first few days of the infection.[13] Basic hygiene including hand washing can prevent transmission.[13] There are no vaccines that have been developed to prevent croup,[13] however, many cases of croup have been prevented by immunization for influenza and diphtheria.[5] At one time, croup referred to a diphtherial disease, but with vaccination, diphtheria is now rare in the developed world.[5]

• #1 Prophylactic inhaled corticosteroids for the management of recurrent croup – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37201337/

  Croup is characterized by a barky cough, inspiratory stridor, hoarseness and varying degrees of respiratory distress. Acute croup episodes are often treated with oral, inhaled, or intravenous corticosteroids. Recurrent croup, defined as more than 2-3 episodes of acute croup in the same patient, can mimic asthma. We hypothesized that inhaled corticosteroids (ICS) given at the first sign of a respiratory viral prodrome can be a safe treatment to reduce the frequency of recurrent croup episodes in children without fixed airway lesions. […] The novel initiation of ICS at the earliest sign of a viral upper respiratory infection shows promise as a safe preventative treatment to mitigate the frequency of recurrent croup episodes.

• #1 Recurrent Croup

  https://pedemmorsels.com/recurrent-croup/

  Recurrent croup is not due to a viral etiology and should be considered a RED FLAG for another condition. […] Recurrent croup should be considered a RED FLAG for something that isn’t as simple as a viral illness. […] Anatomic abnormalities have been reported in a significant proportion of patients with recurrent croup. […] Most, if not all, of these patients will require bronchoscopy by ENT to rule out anatomic abnormalities.

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

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

  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). […] Previously, inhaled corticosteroids (ICS) have been used for acute croup episodes, with suggested benefits as a preventative therapy. In the largest known cohort study of its kind, the team hypothesized prophylactic ICS could potentially decrease both the frequency and severity of recurrent croup episodes in patients without fixed airway lesions. […] 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 Natural Croup Treatment And Prevention Strategies -EmailFacebookInstagramPinterestYouTube

  https://www.naturalsuperkids.com/croup-treatment-prevention/

  Cold air can ease the symptoms and reduce inflammation, giving them immediate relief. […] Acute croup treatment is helpful, but it may not be enough to address the underlying causes. If your child is prone to croup, these tips will help rebalance the immune system and reduce their risk of contracting croup. […] As most cases of recurrent croup are caused by a virus, we want to focus on supporting the immune system. […] The 3 nutrients I always look at for immune support are vitamin C, vitamin D and zinc. […] When it comes to herbal formulas for croup, my favourite is medicinal mushrooms. […] One way to lighten the load on the immune system is to remove anything that might be triggering it. Many kids with recurrent croup have food sensitivities. […] We know that a healthy gut is an essential part of strengthening and regulating the immune system.

• #1 Croup: Diagnosis and Management | AAFP

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

  Corticosteroids should be administered to patients with croup of any severity. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Epinephrine should be administered to patients with moderate to severe croup. […] A Cochrane review showed that nebulized epinephrine reduces symptom scores at 30 minutes, but not at two and six hours; however, it is associated with reduced length of hospitalization.

• #1 Croup – Diagnosis & treatment – Mayo Clinic

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

  Hold your child in a comfortable upright position. […] Offer fluids. For babies, breast milk or formula is fine. For older children, soup or frozen fruit pops may be soothing. […] Encourage rest. Sleep can help your child fight the infection. […] 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. […] Cold preparations available without a prescription aren’t recommended for children of any age. And they can be harmful in children under than 2 years old. Plus, nonprescription cough medicines won’t help croup. […] In most cases of croup, your child won’t need to see a health care provider. However, if symptoms are severe or aren’t responding to home treatment, you should call your provider.

• #1 Croup – Emergency management in children | Children’s Health Queensland

  https://www.childrens.health.qld.gov.au/for-health-professionals/queensland-paediatric-emergency-care-qpec/queensland-paediatric-clinical-guidelines/croup

  Oxygen desaturation may herald an impending complete upper airway obstruction. […] Administer high flow oxygen at 15 L/min via non-rebreather mask to children with life-threatening croup while getting expert help for an anticipated difficult airway. […] Treatments NOT recommended include antibiotics, steam inhalations, cough suppressants, and heliox evidence is limited, and does not support routine use.

• #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: […] Provide humidified or cool air. Although there’s no evidence of benefit from these practices, many parents believe that humid air or cool air helps a child’s breathing.

• #1 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. […] Croup is often a mild illness but can quickly become serious. […] If you are worried, see a health professional. […] 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. […] 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. […] 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.

• #1

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ue5431

  Using techniques to help your child control symptoms of croup can help prevent the need to see a doctor at a clinic or emergency room. […] A croup attack usually can be managed at home. […] If symptoms improve with these methods, put your child back in bed with the humidifier blowing nearby. […] It is important to keep your child well hydrated. […] Your child may have recurrent attacks throughout the night. […] But if at any time your child has severe difficulty breathing, call 911 or other emergency services immediately.

• #2 Croup | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/croup

  Croup is a viral infection of the throat and windpipe that causes noisy breathing, a hoarse voice and a harsh, barking cough. […] You can treat mild croup at home if your child has no breathing problems or noisy breathing when they are not crying. […] The viruses that cause croup are very similar to those of the common cold. They start to be infectious with the first signs, such as a runny nose and cough, and remain infectious for up to 5 days. Only about one in 10 children who get these viruses will develop croup. […] It is important to practice good hygiene by washing hands, coughing and sneezing into the elbow and staying home when unwell. […] It is not usually possible to prevent croup. Many viruses can cause it and there is no immunisation available against most of them. However, immunisation against influenza is recommended as this may actually prevent croup caused by the influenza virus (influenza-induced croup). […] All children who are aged 6 months and older can be immunised against influenza. This is especially important for children with an underlying chronic illness such as asthma or cystic fibrosis. […] Antibiotics will not be of use as the viruses that cause croup will not respond to this treatment.

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

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

  Croup cant generally be prevented, but infection control measures can reduce the spread of viruses that cause croup. […] There is a vaccination available against the influenza virus, one of the viruses that cause croup. For this reason, its a good idea to have your child immunised against influenza. […] Here are some tips to help prevent your child from catching and spreading viruses that can cause croup: If your child has croup, keep them home from school while they recover. Keep your child away from children who are unwell. Wash your childs hands before they eat. When they are old enough, teach your child to cough and sneeze into their elbow or a tissue, and throw used tissues into a rubbish bin straightaway. Encourage your child not to touch their nose, eyes or mouth with their fingers. Be careful about your own hygiene and general health. Offer your child a healthy and nutritious diet that will help to support their immune system.

• #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/print

  CROUP PREVENTION […] Simple hygiene measures can help to prevent infection with the viruses that lead to croup. […] Hygiene and other preventive measures include: […] Frequently wash hands with soap and water – Hands should ideally be wet with water and plain or antimicrobial soap and rubbed together for 15 to 30 seconds. Special attention should be paid to the fingernails, between the fingers, and the wrists. Hands should be rinsed thoroughly and dried with a single-use towel. […] Use alcohol-based hand rubs – These are a good alternative for disinfecting hands if a sink is not available. Hand rubs should be spread over the entire surface of hands, fingers, and wrists until dry and may be used several times. Hand rubs are available as a liquid or wipe in small, portable sizes that are easy to carry in a pocket or handbag. When a sink is available, visibly soiled hands should be washed with soap and water.

• #2 Croup – Symptoms & causes – Mayo Clinic

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

  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. […] Keep your child away from anyone who’s sick. […] Encourage your child to cough or sneeze into the elbow. […] Clean frequently touched surfaces. […] 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. There isn’t a vaccine yet that protects against parainfluenza viruses.

• #2 Is Croup Contagious? Causes, Symptoms, and Prevention

  https://www.volusiamedicalcenter.net/post/is-croup-contagious-causes-symptoms-and-prevention

  Croup is a contagious illness that affects young kids, leading to a barking cough and trouble breathing. […] To stop croup from spreading, practice good hand washing and keep up with vaccinations. By doing this, you can help keep your child healthy and safe. […] Washing your hands regularly with soap and water can help prevent the spread of viruses that cause croup. […] Keep children away from people with respiratory infections, especially if they are coughing or have a fever. […] Cleaning and disinfecting frequently touched objects like toys, doorknobs, and countertops can help reduce the risk of infection. […] Teaching children to cough or sneeze into their elbow or a tissue can help prevent the spread of germs. […] Eating well, sleeping enough, and exercising regularly can make your immune system stronger. […] There isn’t a vaccine that stops croup directly, but vaccines for the flu and other respiratory illnesses can reduce the risk. […] Using a cool-mist humidifier can help keep the air wet and make it easier to breathe.

• #2 Croup & stridor: babies & children | Raising Children Network

  https://raisingchildren.net.au/guides/a-z-health-reference/croup

  Croup prevention […] Your child and family can take simple precautions to prevent the spread of the viruses and bacteria that cause croup and reduce your chances of getting sick: […] Make sure you regularly wash hands with warm, soapy water. […] Keep your hands away from your face as much as possible. […] Cough or sneeze into a tissue or your elbows. […] Croup can sometimes be caused by an influenza virus, so flu immunisation might reduce the chance of your child developing croup. Its recommended that all children over 6 months be immunised against flu every year. […] Croup can also sometimes be caused by the COVID-19 virus, so COVID-19 immunisation might reduce the chance of your child developing croup. Its recommended that some children from 6 months and all children from 5 years be immunised against COVID-19.

• #2 Croup: Causes, Symptoms & Treatment

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

  Croup can spread by physical contact or through the air. To help prevent its spread: […] Wash and dry your hands thoroughly after caring for your child. […] Wash toys between each use. […] Encourage your child to cover their mouth and nose when coughing and sneezing. […] Keep your child home from school or daycare when they’re ill or if outbreaks occur. […] Throw used tissues away.

• #2 Croup – Wikipedia

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

  Many cases of croup are preventable by immunization for influenza and diphtheria.[5] […] Croup is contagious during the first few days of the infection.[13] Basic hygiene including hand washing can prevent transmission.[13] There are no vaccines that have been developed to prevent croup,[13] however, many cases of croup have been prevented by immunization for influenza and diphtheria.[5] At one time, croup referred to a diphtherial disease, but with vaccination, diphtheria is now rare in the developed world.[5]

• #2

  https://healthylife.com/online/FullVersion/HierAtHome/Croup.html

  To Help Prevent Croup and Other Infections […] See that your childs immunizations for diphtheria (DTaP), measles (MMR), and H. influenzae type b (Hib) are up-to-date. (See Immunization Schedule.) […] Follow prevention measures in Colds Flu. […] […] […] Croup is usually caused by a certain virus. Other viruses, allergies, bacteria, and inhaled foreign objects, can mimic croup.

• #2 Croup: MedlinePlus Medical EncyclopediaLock

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

  Some of the steps to be taken to prevent infection are: […] Timely immunizations with the diphtheria, Haemophilus influenzae (Hib), and measles vaccines protect children from some of the most dangerous forms of croup.

• #2 4 Questions to Ask When Your Child Has Recurrent Croup

  https://blog.cincinnatichildrens.org/rare-and-complex-conditions/4-questions-to-ask-when-your-child-has-recurrent-croup/

  Croup can be very scary for parents and children alike, but fortunately it usually sounds worse than it is. Croup is a viral infection that causes swelling or a partial blockage of air as it flows through the larynx, or voice box. The hallmarks of croup are stridor, a harsh, raspy noise when breathing in, and a bark-like noise when coughing. […] If your child has recurrent croup, it is important to rule out any underlying structural issues or narrowing of the airway, called subglottic stenosis. Here are some questions to ask yourself to help determine if your child’s recurrent croup needs to be evaluated by an ENT specialist: […] If you’ve answered yes to any of these questions, I recommend discussing your concerns with your child’s primary care provider. He or she may recommend a referral to an otolaryngologist. During this ENT visit, your child will receive a thorough evaluation to look for structural abnormalities of his upper airway that could include an endoscopy of nose, throat, and vocal cords, x-ray of the neck and bronchoscopy of airway.

• #2 Recurrent Croup

  https://pedemmorsels.com/recurrent-croup/

  Recurrent croup is not due to a viral etiology and should be considered a RED FLAG for another condition. […] Recurrent croup should be considered a RED FLAG for something that isn’t as simple as a viral illness. […] Anatomic abnormalities have been reported in a significant proportion of patients with recurrent croup. […] Most, if not all, of these patients will require bronchoscopy by ENT to rule out anatomic abnormalities.

• #2 Prophylactic inhaled corticosteroids for the management of recurrent croup – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37201337/

  Croup is characterized by a barky cough, inspiratory stridor, hoarseness and varying degrees of respiratory distress. Acute croup episodes are often treated with oral, inhaled, or intravenous corticosteroids. Recurrent croup, defined as more than 2-3 episodes of acute croup in the same patient, can mimic asthma. We hypothesized that inhaled corticosteroids (ICS) given at the first sign of a respiratory viral prodrome can be a safe treatment to reduce the frequency of recurrent croup episodes in children without fixed airway lesions. […] The novel initiation of ICS at the earliest sign of a viral upper respiratory infection shows promise as a safe preventative treatment to mitigate the frequency of recurrent croup episodes.

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

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

  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). […] Previously, inhaled corticosteroids (ICS) have been used for acute croup episodes, with suggested benefits as a preventative therapy. In the largest known cohort study of its kind, the team hypothesized prophylactic ICS could potentially decrease both the frequency and severity of recurrent croup episodes in patients without fixed airway lesions. […] 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.

• #2 Expert Pediatrician McKinney TX: Managing Croup in Children

  https://www.kidsvillepeds.com/blog/1183796-croup-a-comprehensive-parents-guide/

  Croup is a common respiratory illness in young children, characterized by a distinctive barking cough and difficulty breathing. While it is challenging to prevent croup entirely, there are ways to reduce the likelihood of a child contracting the illness. McKinney Pediatrics McKinney TX emphasizes the importance of good hygiene practices in mitigating the risk of croup and other respiratory infections. […] Although no vaccine is available for Human Parainfluenza Viruses (HPIVs), which cause approximately 75% of croup cases, certain hygiene practices can help prevent the transmission of these viruses. […] Key recommendations include: Frequent Hand Washing: Encourage children to wash their hands often with soap and water, especially during child care activities and before meals. Hand hygiene is a critical measure in the prevention and the spread of infections. […] Additionally, breastfeeding can play a significant role in reducing a baby’s risk of developing croup. Breast milk contains vital proteins and antibodies that help boost the baby’s immune system, providing protection against various infections, including those that cause croup.

• #2 Croup – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431070/

  Croup is a common respiratory illness of the trachea, larynx, and bronchi that can lead to inspiratory stridor and barking cough. […] Corticosteroids should be administered to all patients with croup, and epinephrine is reserved in those with moderate to severe croup. […] Treatment depends on the severity based on the Westley croup score. Children with mild croup defined as Westley croup score less than 2 are given a single dose dexamethasone. Children with moderate to severe croup defined as a Westley croup score greater than 3 are given nebulized epinephrine in addition to dexamethasone. […] Corticosteroids, such as dexamethasone, results in faster resolution of symptoms, decreased return to medical care, and decreased length of stay. […] Croup is most commonly a viral disease. Antibiotics are reserved for cases when primary or secondary bacterial infection is suspected.

• #2 Consensus Guidelines for Management of Croup: Northern California Pediatric Hospital Medicine Consortium – UCSF Pediatrics

  https://medconnection.ucsfbenioffchildrens.org/croup-guidelines

  Administer Dexamethasone to all patients with a diagnosis of croup, regardless of symptom severity. […] Do not routinely give repeat doses of steroid. […] Croup symptoms mild or improved from presentation. […] Received dexamethasone. […] Hospital discharge criteria: Croup symptoms mild or improved. […] Able to maintain adequate hydration. […] Dexamethasone: single PO dose. […] Administer for all patients with croup (regardless of severity). […] No evidence supports repeated doses of dexamethasone. […] For severe or atypical cases, repeat steroid doses may be considered; consultation with pediatric subspecialists (PICU, ENT) is recommended. […] Cool mist therapy / moist night air is still recommended + has potential benefit in home setting; recommend to families at ER/hospital discharge. […] Therapies NOT Recommended: Antibiotics. […] Subspecialty consultation (ENT, anesthesia, pulmonology, ID, surgery, etc) indications: Severe / impending respiratory failure. […] Atypical or complicated presentation (rule-out alternative diagnoses).

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

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

  In children with moderate to severe croup treated with corticosteroids, there was a reported average reduction of 12 hours in length of stay in the ED or 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.

• #2 Croup – Emergency management in children | Children’s Health Queensland

  https://www.childrens.health.qld.gov.au/for-health-professionals/queensland-paediatric-emergency-care-qpec/queensland-paediatric-clinical-guidelines/croup

  Oxygen desaturation may herald an impending complete upper airway obstruction. […] Administer high flow oxygen at 15 L/min via non-rebreather mask to children with life-threatening croup while getting expert help for an anticipated difficult airway. […] Treatments NOT recommended include antibiotics, steam inhalations, cough suppressants, and heliox evidence is limited, and does not support routine use.

• #2 Croup

  https://www.asthmafoundation.org.nz/your-health/other-respiratory-conditions/croup

  Croup is caused by a virus so antibiotics do not help. Mild cases of croup can be managed at home and no medication is needed. In moderate to severe croup steroid medication is an effective treatment, which works for about 48 hours. […] There is no evidence to support the practice of adding steam to the air that the child breathes. In fact there have been instances when the child has received burns from the hot water, so this practice is no longer recommended.

• #2

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ue5431

  Using techniques to help your child control symptoms of croup can help prevent the need to see a doctor at a clinic or emergency room. […] A croup attack usually can be managed at home. […] If symptoms improve with these methods, put your child back in bed with the humidifier blowing nearby. […] It is important to keep your child well hydrated. […] Your child may have recurrent attacks throughout the night. […] But if at any time your child has severe difficulty breathing, call 911 or other emergency services immediately.

• #2 Natural Croup Treatment And Prevention Strategies -EmailFacebookInstagramPinterestYouTube

  https://www.naturalsuperkids.com/croup-treatment-prevention/

  Croup is a condition where a virus causes swelling in the larynx and trachea in the windpipe. This leads to a harsh barking cough and a high-pitched noise when inhaling, known as stridor. The swelling can also make it difficult to breathe. […] Most cases of croup will self-resolve, but it’s a good idea to seek medical advice if you are concerned. In severe cases, the skin between the ribs and under the neck will ‘suck in’ when breathing, so if this occurs, see your GP. […] If your child currently has croup, here are some tips to help relieve symptoms naturally. […] As croup is usually caused by a viral infection, you want to make sure you keep your child hydrated. This helps to ensure the mucus is thin and clears easily, which reduces inflammation around the area. […] It’s important that whoever is caring for your child is calm. Struggling to breathe is scary for your child, so if you’re panicking, it will make them panic and exacerbate their symptoms.

• #2 All About Croup

  https://www.nationwidechildrens.org/family-resources-education/700childrens/2017/01/all-about-croup

  Croup is difficult to prevent because the viruses that cause it are common wherever kids gather, especially in the autumn and winter months. The best prevention is to avoid contact with sick children and lots of hand washing! […] Most kids with croup do fine and are better in a few days. However, kids with stridor or difficult breathing may go downhill fast, so it’s important to keep your child’s doctor informed of symptoms and seek help in an urgent care or emergency department if noisy or difficult breathing occurs. There are other conditions that cause stridor and difficult breathing, such as foreign body aspiration and other infections of the upper airway, making it even more important to seek help quickly.

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

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

  Call 111 within New Zealand 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. […] Make sure your child is up to date with all their vaccinations. […] See a health professional if your child has repeated episodes of stridor or barking cough.

• #2 Croup: Home Care (for Parents) | Nemours KidsHealth

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

  Croup is often caused by a viral infection in the upper airway, around the vocal cords and windpipe. Swelling in this area may cause a barking cough. […] What Can Help Prevent Croup? Washing hands well and often and avoiding contact with people who have respiratory infections are the best protection against the spread of viruses that cause croup.

• #3 Croup: An Overview | AAFP

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

  Croup is often caused by viruses, with parainfluenza virus (types 1 to 3) as the most common. […] 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. […] Treatment of croup with corticosteroids is beneficial, even with mild illness. A single dose of an oral corticosteroid is effective in patients with mild croup. […] Nebulized epinephrine improves outcomes in patients with moderate to severe croup. […] Corticosteroid therapy benefits patients with croup presumably by decreasing edema in the laryngeal mucosa, and is usually effective within six hours of treatment. […] Therefore, corticosteroids should be considered even for mild illness.

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

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

  CROUP PREVENTION […] Simple hygiene measures can help to prevent infection with the viruses that lead to croup. […] Hygiene and other preventive measures include: […] Frequently wash hands with soap and water – Hands should ideally be wet with water and plain or antimicrobial soap and rubbed together for 15 to 30 seconds. Special attention should be paid to the fingernails, between the fingers, and the wrists. Hands should be rinsed thoroughly and dried with a single-use towel. […] Use alcohol-based hand rubs – These are a good alternative for disinfecting hands if a sink is not available. Hand rubs should be spread over the entire surface of hands, fingers, and wrists until dry and may be used several times. Hand rubs are available as a liquid or wipe in small, portable sizes that are easy to carry in a pocket or handbag. When a sink is available, visibly soiled hands should be washed with soap and water.

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

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

  Avoid close contact with other adults and children with upper respiratory infection when possible – This may be difficult, especially when in public, but parents/caregivers can try to limit direct contact. In addition, infants or children who are sick should not be sent to daycare or school, as this can spread the illness to others. […] Ensure the child is vaccinated – There are no vaccines against the most common virus that cause croup (parainfluenza virus). However, vaccines are recommended for other viruses that can cause croup (influenza, COVID-19, and measles).

• #3 What is Croup? Prevention, Signs & When to go to the ER – Altus Emergency Centers

  https://www.altusemergency.com/blog/what-is-croup-prevention-signs-when-to-go-to-the-er/

  Way to Prevent the Spread of Croup […] Like other viral respiratory infections, croup can spread through physical contact or the air. The following tips can help prevent the spread of croup in your household and community. […] Wash your hands before and after caring for your baby or young child […] Wash toys frequently, especially if your children share them with others […] Urge your child to cover their nose and mouth when coughing or sneezing […] Avoid sending your child to school or daycare if they are ill or when the school informs you of an outbreak […] Teach your children the proper way to wash their hands and when to wash them […] Throw away used tissues

• #3 Croup | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/croup

  Croup is a viral infection of the throat and windpipe that causes noisy breathing, a hoarse voice and a harsh, barking cough. […] You can treat mild croup at home if your child has no breathing problems or noisy breathing when they are not crying. […] The viruses that cause croup are very similar to those of the common cold. They start to be infectious with the first signs, such as a runny nose and cough, and remain infectious for up to 5 days. Only about one in 10 children who get these viruses will develop croup. […] It is important to practice good hygiene by washing hands, coughing and sneezing into the elbow and staying home when unwell. […] It is not usually possible to prevent croup. Many viruses can cause it and there is no immunisation available against most of them. However, immunisation against influenza is recommended as this may actually prevent croup caused by the influenza virus (influenza-induced croup). […] All children who are aged 6 months and older can be immunised against influenza. This is especially important for children with an underlying chronic illness such as asthma or cystic fibrosis. […] Antibiotics will not be of use as the viruses that cause croup will not respond to this treatment.

• #3 Croup – Symptoms & causes – Mayo Clinic

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

  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. […] Keep your child away from anyone who’s sick. […] Encourage your child to cough or sneeze into the elbow. […] Clean frequently touched surfaces. […] 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. There isn’t a vaccine yet that protects against parainfluenza viruses.

• #3 4 Questions to Ask When Your Child Has Recurrent Croup

  https://blog.cincinnatichildrens.org/rare-and-complex-conditions/4-questions-to-ask-when-your-child-has-recurrent-croup/

  Croup can be very scary for parents and children alike, but fortunately it usually sounds worse than it is. Croup is a viral infection that causes swelling or a partial blockage of air as it flows through the larynx, or voice box. The hallmarks of croup are stridor, a harsh, raspy noise when breathing in, and a bark-like noise when coughing. […] If your child has recurrent croup, it is important to rule out any underlying structural issues or narrowing of the airway, called subglottic stenosis. Here are some questions to ask yourself to help determine if your child’s recurrent croup needs to be evaluated by an ENT specialist: […] If you’ve answered yes to any of these questions, I recommend discussing your concerns with your child’s primary care provider. He or she may recommend a referral to an otolaryngologist. During this ENT visit, your child will receive a thorough evaluation to look for structural abnormalities of his upper airway that could include an endoscopy of nose, throat, and vocal cords, x-ray of the neck and bronchoscopy of airway.

• #3 Prophylactic inhaled corticosteroids for the management of recurrent croup – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37201337/

  Croup is characterized by a barky cough, inspiratory stridor, hoarseness and varying degrees of respiratory distress. Acute croup episodes are often treated with oral, inhaled, or intravenous corticosteroids. Recurrent croup, defined as more than 2-3 episodes of acute croup in the same patient, can mimic asthma. We hypothesized that inhaled corticosteroids (ICS) given at the first sign of a respiratory viral prodrome can be a safe treatment to reduce the frequency of recurrent croup episodes in children without fixed airway lesions. […] The novel initiation of ICS at the earliest sign of a viral upper respiratory infection shows promise as a safe preventative treatment to mitigate the frequency of recurrent croup episodes.

• #3 Natural Croup Treatment And Prevention Strategies -EmailFacebookInstagramPinterestYouTube

  https://www.naturalsuperkids.com/croup-treatment-prevention/

  Cold air can ease the symptoms and reduce inflammation, giving them immediate relief. […] Acute croup treatment is helpful, but it may not be enough to address the underlying causes. If your child is prone to croup, these tips will help rebalance the immune system and reduce their risk of contracting croup. […] As most cases of recurrent croup are caused by a virus, we want to focus on supporting the immune system. […] The 3 nutrients I always look at for immune support are vitamin C, vitamin D and zinc. […] When it comes to herbal formulas for croup, my favourite is medicinal mushrooms. […] One way to lighten the load on the immune system is to remove anything that might be triggering it. Many kids with recurrent croup have food sensitivities. […] We know that a healthy gut is an essential part of strengthening and regulating the immune system.

• #3 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. […] Overall, children treated with corticosteroids have fewer return visits or admissions to the hospital. Fully one-half of children with mild croup treated with corticosteroids are unlikely to need further medical care for ongoing symptoms.

• #3 Croup – Emergency management in children | Children’s Health Queensland

  https://www.childrens.health.qld.gov.au/for-health-professionals/queensland-paediatric-emergency-care-qpec/queensland-paediatric-clinical-guidelines/croup

  Croup is a common cause of airway obstruction in young children. […] Treatment includes corticosteroids and, in moderate to severe cases, nebulised adrenaline. […] Croup results from inflammation of the upper airway, including the larynx and trachea. […] Recommended management includes: The appropriate use of corticosteroids and nebulised Adrenaline. These interventions have been shown to reduce the need for, and duration of endotracheal intubation, length of stay, and representation rates to emergency services. […] Recommended for all children with croup. […] Oral corticosteroids take approximately 30 minutes to lessen respiratory distress, and if not tolerated, can be more reliably given via a nebuliser. […] Adrenaline is thought to work by reducing bronchial and tracheal epithelial vascular permeability thereby decreasing airway oedema, increasing the airway radius and improving airflow.

• #3 PrimeCare PediatricsCroup (Laryngotracheobronchitis) – PrimeCare Pediatrics

  https://www.primecarepeds.com/croup-laryngotracheobronchitis/

  Croup is a condition caused by an upper viral respiratory infection in young children. […] Croup is more commonly encountered in late fall and winter months. Since croup is a viral illness, antibiotics cannot be used to treat it. […] The routine use of steroids has decreased the frequency of severe croup and hospital admission. […] Steroids are the standard treatment for croup. Steroids have been shown to prevent mild croup from becoming severe. […] Hand-washing and good general hygiene. Croup viruses are spread through respiratory secretions. […] Keep children who have croup at home until they have sufficiently recovered. This will afford them the rest they need to recover, and also prevent the exposure of other children. […] Croup is contagious, but like other viral illnesses the spread of the infection is almost impossible to prevent.

• #3 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. […] Croup is often a mild illness but can quickly become serious. […] If you are worried, see a health professional. […] 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. […] 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. […] 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.

• #3 Croup – Diagnosis & treatment – Mayo Clinic

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

  Hold your child in a comfortable upright position. […] Offer fluids. For babies, breast milk or formula is fine. For older children, soup or frozen fruit pops may be soothing. […] Encourage rest. Sleep can help your child fight the infection. […] 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. […] Cold preparations available without a prescription aren’t recommended for children of any age. And they can be harmful in children under than 2 years old. Plus, nonprescription cough medicines won’t help croup. […] In most cases of croup, your child won’t need to see a health care provider. However, if symptoms are severe or aren’t responding to home treatment, you should call your provider.

• #4 Croup (laryngotracheitis and laryngotracheobronchitis) | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/laryngotracheitis-and-laryngotracheobronchitis-croup-16689220.html

  Common viral respiratory infection with peak incidence amongst children between 6 months and 3 years. […] In the absence of inspiratory stridor or intercostal, subcostal or sternal retractions, treat symptomatically: ensure adequate hydration, seek medical attention if symptoms worsen (e.g. respiratory difficulty, noisy breathing, inability to tolerate oral fluids). […] If danger signs are present (stridor at rest, respiratory distress, hypoxia) or the child is unable to drink, admit to hospital. […] Administer oxygen continuously if respiratory distress or SpO2 92%: maintain SpO2 between 94 and 98% (or if SpO2 cannot be determined, at least 5 litres/minute). […] Corticosteroids: dexamethasone PO: 0.15 to 0.6 mg/kg (max. 16 mg) […] If the patient has a complete airway obstruction, intubation if possible or emergency tracheotomy.

• #4 Croup: Causes, Symptoms & Treatment

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

  Croup can spread by physical contact or through the air. To help prevent its spread: […] Wash and dry your hands thoroughly after caring for your child. […] Wash toys between each use. […] Encourage your child to cover their mouth and nose when coughing and sneezing. […] Keep your child home from school or daycare when they’re ill or if outbreaks occur. […] Throw used tissues away.

• #4 Croup in Children

  http://healthlibrary.umcno.org/Library/PreventionGuidelines/90,P02942

  Croup is a common infection in children. It causes swelling in the upper part of the airway in the neck. […] Here are tips to prevent the spread of croup: Wash your hands often. Teach your child how to correctly wash their hands. Stop your child from sharing cups and other dishware. Keep your child at home until they are better. […] Correct handwashing is one way to prevent croup.

• #4 Expert Pediatrician McKinney TX: Managing Croup in Children

  https://www.kidsvillepeds.com/blog/1183796-croup-a-comprehensive-parents-guide/

  While there is currently no vaccine for HPIVs, research is ongoing to develop one. However, vaccines are available for other infections that can lead to croup. McKinney pediatrics McKinney TX experts advise parents to ensure their children are up-to-date with these vaccinations, which include: Influenza Vaccines: Influenza A and B can cause croup, and annual flu vaccinations are recommended for all children over six months of age. Flu vaccines help reduce the incidence of influenza-related croup cases. […] By adopting these preventive measures, parents can help protect their children from the discomfort and potential complications associated with croup. Regular check-ups and consultations with pediatricians can provide further guidance and support in maintaining children’s health and well-being.

• #4 Is Croup Contagious to Children or Adults? Plus, Prevention

  https://www.healthline.com/health/is-croup-contagious

  There are also vaccines available for some bacterial infections that cause illnesses similar to severe croup. These include the Haemophilus influenzae type b (Hib) vaccine and the diphtheria vaccine. Only certain adults at high risk will qualify for the Hib vaccine. […] Making sure that both you and your child receive these vaccines can protect against these more serious infections. Be sure to follow the routine vaccine schedules for adults and for children.

• #4 4 Questions to Ask When Your Child Has Recurrent Croup

  https://blog.cincinnatichildrens.org/rare-and-complex-conditions/4-questions-to-ask-when-your-child-has-recurrent-croup/

  Croup can be very scary for parents and children alike, but fortunately it usually sounds worse than it is. Croup is a viral infection that causes swelling or a partial blockage of air as it flows through the larynx, or voice box. The hallmarks of croup are stridor, a harsh, raspy noise when breathing in, and a bark-like noise when coughing. […] If your child has recurrent croup, it is important to rule out any underlying structural issues or narrowing of the airway, called subglottic stenosis. Here are some questions to ask yourself to help determine if your child’s recurrent croup needs to be evaluated by an ENT specialist: […] If you’ve answered yes to any of these questions, I recommend discussing your concerns with your child’s primary care provider. He or she may recommend a referral to an otolaryngologist. During this ENT visit, your child will receive a thorough evaluation to look for structural abnormalities of his upper airway that could include an endoscopy of nose, throat, and vocal cords, x-ray of the neck and bronchoscopy of airway.

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

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

  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). […] Previously, inhaled corticosteroids (ICS) have been used for acute croup episodes, with suggested benefits as a preventative therapy. In the largest known cohort study of its kind, the team hypothesized prophylactic ICS could potentially decrease both the frequency and severity of recurrent croup episodes in patients without fixed airway lesions. […] 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.

• #4 Is Croup Contagious? Causes, Symptoms, and Prevention

  https://www.volusiamedicalcenter.net/post/is-croup-contagious-causes-symptoms-and-prevention

  Croup is a contagious illness that affects young kids, leading to a barking cough and trouble breathing. […] To stop croup from spreading, practice good hand washing and keep up with vaccinations. By doing this, you can help keep your child healthy and safe. […] Washing your hands regularly with soap and water can help prevent the spread of viruses that cause croup. […] Keep children away from people with respiratory infections, especially if they are coughing or have a fever. […] Cleaning and disinfecting frequently touched objects like toys, doorknobs, and countertops can help reduce the risk of infection. […] Teaching children to cough or sneeze into their elbow or a tissue can help prevent the spread of germs. […] Eating well, sleeping enough, and exercising regularly can make your immune system stronger. […] There isn’t a vaccine that stops croup directly, but vaccines for the flu and other respiratory illnesses can reduce the risk. […] Using a cool-mist humidifier can help keep the air wet and make it easier to breathe.

• #4 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. It can help prevent hospitalization or help a child who is hospitalized with moderate to severe croup; hospitalized children who do not respond quickly may require several doses. […] Hospitalization is typically indicated for increasing or persistent respiratory distress, tachycardia, fatigue, cyanosis or hypoxemia, dehydration.

• #4 Croup: Diagnosis and Management | AAFP

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

  Corticosteroids should be administered to patients with croup of any severity. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Epinephrine should be administered to patients with moderate to severe croup. […] A Cochrane review showed that nebulized epinephrine reduces symptom scores at 30 minutes, but not at two and six hours; however, it is associated with reduced length of hospitalization.

• #4 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. […] 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.

• #4 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. […] If your child is struggling to breathe or making loud sounds when breathing, looks very pale and drowsy, has blue lips, or cannot swallow, call an ambulance (000) immediately. […] While croup itself is not contagious, the viruses that cause it are. These viruses spread mainly when an infected person coughs or sneezes. The best way to stop the spread of croup is to teach your child to practice good hygiene, such as washing their hands regularly and covering their cough.

• #4 Croup – Symptoms & causes – Mayo Clinic

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

  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. […] Keep your child away from anyone who’s sick. […] Encourage your child to cough or sneeze into the elbow. […] Clean frequently touched surfaces. […] 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. There isn’t a vaccine yet that protects against parainfluenza viruses.

• #5 Croup in Children

  http://healthlibrary.umcno.org/Library/PreventionGuidelines/90,P02942

  Croup is a common infection in children. It causes swelling in the upper part of the airway in the neck. […] Here are tips to prevent the spread of croup: Wash your hands often. Teach your child how to correctly wash their hands. Stop your child from sharing cups and other dishware. Keep your child at home until they are better. […] Correct handwashing is one way to prevent croup.

• #5 Croup & stridor: babies & children | Raising Children Network

  https://raisingchildren.net.au/guides/a-z-health-reference/croup

  Talk to your GP for more information about getting your child immunised. […] To minimise the spread of the virus that caused your childs croup, keep your child away from child care, preschool or school while your child is sick. Your child is usually contagious for 3 days after the illness has started, or until the fever has gone.

• #5 Croup Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/croup.html

  To help prevent viral infections that can cause croup: […] Wash your hands frequently, especially after you blow your nose. Also, wash your hands after you care for someone who has a cough, cold or sore throat. […] If someone in your household has a respiratory infection, keep his or her eating utensils and drinking glasses separate from those of other family members. Wash these glasses and utensils thoroughly in hot, soapy water. […] If a toddler with a respiratory infection has been chewing or sucking on toys, wash these toys with soap and water and then rinse them well. […] Promptly dispose of dirty tissues from runny noses and sneezes. […] Ask anyone with a cough or cold to avoid kissing or playing with your child.

• #5 Croup: MedlinePlus Medical EncyclopediaLock

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

  Some of the steps to be taken to prevent infection are: […] Timely immunizations with the diphtheria, Haemophilus influenzae (Hib), and measles vaccines protect children from some of the most dangerous forms of croup.

• #5 Natural Croup Treatment And Prevention Strategies -EmailFacebookInstagramPinterestYouTube

  https://www.naturalsuperkids.com/croup-treatment-prevention/

  Cold air can ease the symptoms and reduce inflammation, giving them immediate relief. […] Acute croup treatment is helpful, but it may not be enough to address the underlying causes. If your child is prone to croup, these tips will help rebalance the immune system and reduce their risk of contracting croup. […] As most cases of recurrent croup are caused by a virus, we want to focus on supporting the immune system. […] The 3 nutrients I always look at for immune support are vitamin C, vitamin D and zinc. […] When it comes to herbal formulas for croup, my favourite is medicinal mushrooms. […] One way to lighten the load on the immune system is to remove anything that might be triggering it. Many kids with recurrent croup have food sensitivities. […] We know that a healthy gut is an essential part of strengthening and regulating the immune system.

• #5 Croup Clinical Pathway — Emergency Department and Inpatient | Children’s Hospital of Philadelphia

  https://www.chop.edu/clinical-pathway/croup-emergency-department-and-inpatient-clinical-pathway

  Dexamethasone 0.3 mg/kg (max 8 mg) […] If continued severe symptoms or impending respiratory failure, consider advanced therapeutics (e.g., heliox, PPV) and ICU admission […] Consider: Repeat dexamethasone […] An Update Highlighting the Effectiveness of 0.15 mg/kg of Dexamethasone […] Comparison Between Single-dose Oral Prednisolone and Oral Dexamethasone for the Treatment of Croup: A Randomized, Double-blind Clinical Trial […] A Randomized Comparison of Dexamethasone 0.15 mg/kg Versus 0.6 mg/kg for the Treatment of Moderate to Severe Croup […] Efficacy of a Small Single Dose of Oral Dexamethasone for Outpatient Croup: a Double Blind Placebo Controlled Clinical Trial […] Oral Dexamethasone in the Treatment of Croup: 0.15 mg/kg Versus 0.3 mg/kg Versus 0.6 mg/kg

• #5 Croup: An Overview | AAFP

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

  Based on expert opinion and consensus, dexamethasone is the recommended corticosteroid for treatment of croup because of its longer half-life (a single dose provides anti-inflammatory effects over the usual symptom duration of 72 hours). […] A recent randomized controlled trial found that a single dose of an oral corticosteroid benefited children with mild croup. […] 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.

• #5 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: […] Provide humidified or cool air. Although there’s no evidence of benefit from these practices, many parents believe that humid air or cool air helps a child’s breathing.

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

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

  Call 111 within New Zealand 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. […] Make sure your child is up to date with all their vaccinations. […] See a health professional if your child has repeated episodes of stridor or barking cough.

• #5 Croup – Symptoms & causes – Mayo Clinic

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

  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. […] Keep your child away from anyone who’s sick. […] Encourage your child to cough or sneeze into the elbow. […] Clean frequently touched surfaces. […] 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. There isn’t a vaccine yet that protects against parainfluenza viruses.

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

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

  Croup cant generally be prevented, but infection control measures can reduce the spread of viruses that cause croup. […] There is a vaccination available against the influenza virus, one of the viruses that cause croup. For this reason, its a good idea to have your child immunised against influenza. […] Here are some tips to help prevent your child from catching and spreading viruses that can cause croup: If your child has croup, keep them home from school while they recover. Keep your child away from children who are unwell. Wash your childs hands before they eat. When they are old enough, teach your child to cough and sneeze into their elbow or a tissue, and throw used tissues into a rubbish bin straightaway. Encourage your child not to touch their nose, eyes or mouth with their fingers. Be careful about your own hygiene and general health. Offer your child a healthy and nutritious diet that will help to support their immune system.

• #6 Croup vaccine, treatments, home remedies, and prevention

  https://www.medicalnewstoday.com/articles/croup-vaccine

  Croup is difficult to prevent, but it may be possible to decrease a childs chances of contracting croup. […] Although no vaccine is available, good hygiene practices can reduce the risk of transmitting HPIVs. These practices may include: washing the hands often with soap and water, which is especially important during child care; avoiding physical contact with the eyes, nose, and mouth; avoiding close contact with other people during periods of sickness; wearing a face mask, which may help prevent transmission of HPIVs. […] Breastfeeding or chestfeeding may also reduce a babys risk of developing croup. Breast milk contains vital proteins that help a babys body defend itself against infections. […] Vaccination for influenza and diphtheria may reduce the number of children who get croup. […] Good hygiene practices and breastfeeding or chestfeeding may help people reduce a childs chances of developing croup.

• #6 Croup Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/croup.html

  To help prevent viral infections that can cause croup: […] Wash your hands frequently, especially after you blow your nose. Also, wash your hands after you care for someone who has a cough, cold or sore throat. […] If someone in your household has a respiratory infection, keep his or her eating utensils and drinking glasses separate from those of other family members. Wash these glasses and utensils thoroughly in hot, soapy water. […] If a toddler with a respiratory infection has been chewing or sucking on toys, wash these toys with soap and water and then rinse them well. […] Promptly dispose of dirty tissues from runny noses and sneezes. […] Ask anyone with a cough or cold to avoid kissing or playing with your child.

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

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

  Croup is highly contagious. It is carried through the air in droplets from coughing and sneezing that may land on toys and other surfaces. This makes it hard to prevent, but you can help stop it from spreading by doing the following: […] While there is no vaccine for croup or the viruses that cause most cases, keeping other vaccinations up to date — the flu and measles vaccines, in particular — will help your child avoid the most serious respiratory infections.

• #6 Croup (laryngotracheitis and laryngotracheobronchitis) | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/laryngotracheitis-and-laryngotracheobronchitis-croup-16689220.html

  Common viral respiratory infection with peak incidence amongst children between 6 months and 3 years. […] In the absence of inspiratory stridor or intercostal, subcostal or sternal retractions, treat symptomatically: ensure adequate hydration, seek medical attention if symptoms worsen (e.g. respiratory difficulty, noisy breathing, inability to tolerate oral fluids). […] If danger signs are present (stridor at rest, respiratory distress, hypoxia) or the child is unable to drink, admit to hospital. […] Administer oxygen continuously if respiratory distress or SpO2 92%: maintain SpO2 between 94 and 98% (or if SpO2 cannot be determined, at least 5 litres/minute). […] Corticosteroids: dexamethasone PO: 0.15 to 0.6 mg/kg (max. 16 mg) […] If the patient has a complete airway obstruction, intubation if possible or emergency tracheotomy.

• #6 Croup: Diagnosis and Management | AAFP

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

  Corticosteroids should be administered to patients with croup of any severity. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Epinephrine should be administered to patients with moderate to severe croup. […] A Cochrane review showed that nebulized epinephrine reduces symptom scores at 30 minutes, but not at two and six hours; however, it is associated with reduced length of hospitalization.

• #6 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. […] 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.

• #6 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. […] If your child is struggling to breathe or making loud sounds when breathing, looks very pale and drowsy, has blue lips, or cannot swallow, call an ambulance (000) immediately. […] While croup itself is not contagious, the viruses that cause it are. These viruses spread mainly when an infected person coughs or sneezes. The best way to stop the spread of croup is to teach your child to practice good hygiene, such as washing their hands regularly and covering their cough.

• #6 Croup – Wikipedia

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

  Many cases of croup are preventable by immunization for influenza and diphtheria.[5] […] Croup is contagious during the first few days of the infection.[13] Basic hygiene including hand washing can prevent transmission.[13] There are no vaccines that have been developed to prevent croup,[13] however, many cases of croup have been prevented by immunization for influenza and diphtheria.[5] At one time, croup referred to a diphtherial disease, but with vaccination, diphtheria is now rare in the developed world.[5]

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

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

  Croup cant generally be prevented, but infection control measures can reduce the spread of viruses that cause croup. […] There is a vaccination available against the influenza virus, one of the viruses that cause croup. For this reason, its a good idea to have your child immunised against influenza. […] Here are some tips to help prevent your child from catching and spreading viruses that can cause croup: If your child has croup, keep them home from school while they recover. Keep your child away from children who are unwell. Wash your childs hands before they eat. When they are old enough, teach your child to cough and sneeze into their elbow or a tissue, and throw used tissues into a rubbish bin straightaway. Encourage your child not to touch their nose, eyes or mouth with their fingers. Be careful about your own hygiene and general health. Offer your child a healthy and nutritious diet that will help to support their immune system.

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

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

  Avoid close contact with other adults and children with upper respiratory infection when possible – This may be difficult, especially when in public, but parents/caregivers can try to limit direct contact. In addition, infants or children who are sick should not be sent to daycare or school, as this can spread the illness to others. […] Ensure the child is vaccinated – There are no vaccines against the most common virus that cause croup (parainfluenza virus). However, vaccines are recommended for other viruses that can cause croup (influenza, COVID-19, and measles).

• #7 Croup: Diagnosis and Management | AAFP

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

  Corticosteroids should be administered to patients with croup of any severity. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Epinephrine should be administered to patients with moderate to severe croup. […] A Cochrane review showed that nebulized epinephrine reduces symptom scores at 30 minutes, but not at two and six hours; however, it is associated with reduced length of hospitalization.

• #7 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.

• #7 Croup (laryngotracheitis and laryngotracheobronchitis) | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/laryngotracheitis-and-laryngotracheobronchitis-croup-16689220.html

  Common viral respiratory infection with peak incidence amongst children between 6 months and 3 years. […] In the absence of inspiratory stridor or intercostal, subcostal or sternal retractions, treat symptomatically: ensure adequate hydration, seek medical attention if symptoms worsen (e.g. respiratory difficulty, noisy breathing, inability to tolerate oral fluids). […] If danger signs are present (stridor at rest, respiratory distress, hypoxia) or the child is unable to drink, admit to hospital. […] Administer oxygen continuously if respiratory distress or SpO2 92%: maintain SpO2 between 94 and 98% (or if SpO2 cannot be determined, at least 5 litres/minute). […] Corticosteroids: dexamethasone PO: 0.15 to 0.6 mg/kg (max. 16 mg) […] If the patient has a complete airway obstruction, intubation if possible or emergency tracheotomy.

• #7 Recurrent Croup

  https://pedemmorsels.com/recurrent-croup/

  Recurrent croup is not due to a viral etiology and should be considered a RED FLAG for another condition. […] Recurrent croup should be considered a RED FLAG for something that isn’t as simple as a viral illness. […] Anatomic abnormalities have been reported in a significant proportion of patients with recurrent croup. […] Most, if not all, of these patients will require bronchoscopy by ENT to rule out anatomic abnormalities.

• #8 Croup & stridor: babies & children | Raising Children Network

  https://raisingchildren.net.au/guides/a-z-health-reference/croup

  Croup prevention […] Your child and family can take simple precautions to prevent the spread of the viruses and bacteria that cause croup and reduce your chances of getting sick: […] Make sure you regularly wash hands with warm, soapy water. […] Keep your hands away from your face as much as possible. […] Cough or sneeze into a tissue or your elbows. […] Croup can sometimes be caused by an influenza virus, so flu immunisation might reduce the chance of your child developing croup. Its recommended that all children over 6 months be immunised against flu every year. […] Croup can also sometimes be caused by the COVID-19 virus, so COVID-19 immunisation might reduce the chance of your child developing croup. Its recommended that some children from 6 months and all children from 5 years be immunised against COVID-19.

• #8 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. […] Overall, children treated with corticosteroids have fewer return visits or admissions to the hospital. Fully one-half of children with mild croup treated with corticosteroids are unlikely to need further medical care for ongoing symptoms.

• #8 Natural Croup Treatment And Prevention Strategies -EmailFacebookInstagramPinterestYouTube

  https://www.naturalsuperkids.com/croup-treatment-prevention/

  Cold air can ease the symptoms and reduce inflammation, giving them immediate relief. […] Acute croup treatment is helpful, but it may not be enough to address the underlying causes. If your child is prone to croup, these tips will help rebalance the immune system and reduce their risk of contracting croup. […] As most cases of recurrent croup are caused by a virus, we want to focus on supporting the immune system. […] The 3 nutrients I always look at for immune support are vitamin C, vitamin D and zinc. […] When it comes to herbal formulas for croup, my favourite is medicinal mushrooms. […] One way to lighten the load on the immune system is to remove anything that might be triggering it. Many kids with recurrent croup have food sensitivities. […] We know that a healthy gut is an essential part of strengthening and regulating the immune system.

• #8 Croup – Diagnosis & treatment – Mayo Clinic

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

  Hold your child in a comfortable upright position. […] Offer fluids. For babies, breast milk or formula is fine. For older children, soup or frozen fruit pops may be soothing. […] Encourage rest. Sleep can help your child fight the infection. […] 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. […] Cold preparations available without a prescription aren’t recommended for children of any age. And they can be harmful in children under than 2 years old. Plus, nonprescription cough medicines won’t help croup. […] In most cases of croup, your child won’t need to see a health care provider. However, if symptoms are severe or aren’t responding to home treatment, you should call your provider.

• #8 4 Questions to Ask When Your Child Has Recurrent Croup

  https://blog.cincinnatichildrens.org/rare-and-complex-conditions/4-questions-to-ask-when-your-child-has-recurrent-croup/

  Croup can be very scary for parents and children alike, but fortunately it usually sounds worse than it is. Croup is a viral infection that causes swelling or a partial blockage of air as it flows through the larynx, or voice box. The hallmarks of croup are stridor, a harsh, raspy noise when breathing in, and a bark-like noise when coughing. […] If your child has recurrent croup, it is important to rule out any underlying structural issues or narrowing of the airway, called subglottic stenosis. Here are some questions to ask yourself to help determine if your child’s recurrent croup needs to be evaluated by an ENT specialist: […] If you’ve answered yes to any of these questions, I recommend discussing your concerns with your child’s primary care provider. He or she may recommend a referral to an otolaryngologist. During this ENT visit, your child will receive a thorough evaluation to look for structural abnormalities of his upper airway that could include an endoscopy of nose, throat, and vocal cords, x-ray of the neck and bronchoscopy of airway.

• #9 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. […] Overall, children treated with corticosteroids have fewer return visits or admissions to the hospital. Fully one-half of children with mild croup treated with corticosteroids are unlikely to need further medical care for ongoing symptoms.

• #9 Croup – Diagnosis & treatment – Mayo Clinic

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

  Hold your child in a comfortable upright position. […] Offer fluids. For babies, breast milk or formula is fine. For older children, soup or frozen fruit pops may be soothing. […] Encourage rest. Sleep can help your child fight the infection. […] 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. […] Cold preparations available without a prescription aren’t recommended for children of any age. And they can be harmful in children under than 2 years old. Plus, nonprescription cough medicines won’t help croup. […] In most cases of croup, your child won’t need to see a health care provider. However, if symptoms are severe or aren’t responding to home treatment, you should call your provider.

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

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

  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). […] Previously, inhaled corticosteroids (ICS) have been used for acute croup episodes, with suggested benefits as a preventative therapy. In the largest known cohort study of its kind, the team hypothesized prophylactic ICS could potentially decrease both the frequency and severity of recurrent croup episodes in patients without fixed airway lesions. […] 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.

• #10 Croup – Diagnosis & treatment – Mayo Clinic

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

  Hold your child in a comfortable upright position. […] Offer fluids. For babies, breast milk or formula is fine. For older children, soup or frozen fruit pops may be soothing. […] Encourage rest. Sleep can help your child fight the infection. […] 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. […] Cold preparations available without a prescription aren’t recommended for children of any age. And they can be harmful in children under than 2 years old. Plus, nonprescription cough medicines won’t help croup. […] In most cases of croup, your child won’t need to see a health care provider. However, if symptoms are severe or aren’t responding to home treatment, you should call your provider.

• #10 Prophylactic inhaled corticosteroids for the management of recurrent croup – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37201337/

  Croup is characterized by a barky cough, inspiratory stridor, hoarseness and varying degrees of respiratory distress. Acute croup episodes are often treated with oral, inhaled, or intravenous corticosteroids. Recurrent croup, defined as more than 2-3 episodes of acute croup in the same patient, can mimic asthma. We hypothesized that inhaled corticosteroids (ICS) given at the first sign of a respiratory viral prodrome can be a safe treatment to reduce the frequency of recurrent croup episodes in children without fixed airway lesions. […] The novel initiation of ICS at the earliest sign of a viral upper respiratory infection shows promise as a safe preventative treatment to mitigate the frequency of recurrent croup episodes.

• #11 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.

• #11 Croup vaccine, treatments, home remedies, and prevention

  https://www.medicalnewstoday.com/articles/croup-vaccine

  Croup is difficult to prevent, but it may be possible to decrease a childs chances of contracting croup. […] Although no vaccine is available, good hygiene practices can reduce the risk of transmitting HPIVs. These practices may include: washing the hands often with soap and water, which is especially important during child care; avoiding physical contact with the eyes, nose, and mouth; avoiding close contact with other people during periods of sickness; wearing a face mask, which may help prevent transmission of HPIVs. […] Breastfeeding or chestfeeding may also reduce a babys risk of developing croup. Breast milk contains vital proteins that help a babys body defend itself against infections. […] Vaccination for influenza and diphtheria may reduce the number of children who get croup. […] Good hygiene practices and breastfeeding or chestfeeding may help people reduce a childs chances of developing croup.

• #12 Croup – Diagnosis & treatment – Mayo Clinic

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

  Hold your child in a comfortable upright position. […] Offer fluids. For babies, breast milk or formula is fine. For older children, soup or frozen fruit pops may be soothing. […] Encourage rest. Sleep can help your child fight the infection. […] 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. […] Cold preparations available without a prescription aren’t recommended for children of any age. And they can be harmful in children under than 2 years old. Plus, nonprescription cough medicines won’t help croup. […] In most cases of croup, your child won’t need to see a health care provider. However, if symptoms are severe or aren’t responding to home treatment, you should call your provider.

• #12 Expert Pediatrician McKinney TX: Managing Croup in Children

  https://www.kidsvillepeds.com/blog/1183796-croup-a-comprehensive-parents-guide/

  Croup is a common respiratory illness in young children, characterized by a distinctive barking cough and difficulty breathing. While it is challenging to prevent croup entirely, there are ways to reduce the likelihood of a child contracting the illness. McKinney Pediatrics McKinney TX emphasizes the importance of good hygiene practices in mitigating the risk of croup and other respiratory infections. […] Although no vaccine is available for Human Parainfluenza Viruses (HPIVs), which cause approximately 75% of croup cases, certain hygiene practices can help prevent the transmission of these viruses. […] Key recommendations include: Frequent Hand Washing: Encourage children to wash their hands often with soap and water, especially during child care activities and before meals. Hand hygiene is a critical measure in the prevention and the spread of infections. […] Additionally, breastfeeding can play a significant role in reducing a baby’s risk of developing croup. Breast milk contains vital proteins and antibodies that help boost the baby’s immune system, providing protection against various infections, including those that cause croup.

• #13 Croup: Diagnosis and Management | AAFP

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

  Corticosteroids should be administered to patients with croup of any severity. […] Dexamethasone is the preferred corticosteroid because it is given as a single dose and can be given orally, intramuscularly, or intravenously. […] Treatment with dexamethasone results in faster resolution of symptoms and decreased return to medical care. […] Epinephrine should be administered to patients with moderate to severe croup. […] A Cochrane review showed that nebulized epinephrine reduces symptom scores at 30 minutes, but not at two and six hours; however, it is associated with reduced length of hospitalization.

• #14 Croup – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431070/

  Croup is a common respiratory illness of the trachea, larynx, and bronchi that can lead to inspiratory stridor and barking cough. […] Corticosteroids should be administered to all patients with croup, and epinephrine is reserved in those with moderate to severe croup. […] Treatment depends on the severity based on the Westley croup score. Children with mild croup defined as Westley croup score less than 2 are given a single dose dexamethasone. Children with moderate to severe croup defined as a Westley croup score greater than 3 are given nebulized epinephrine in addition to dexamethasone. […] Corticosteroids, such as dexamethasone, results in faster resolution of symptoms, decreased return to medical care, and decreased length of stay. […] Croup is most commonly a viral disease. Antibiotics are reserved for cases when primary or secondary bacterial infection is suspected.

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