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đ€ Croup Management - #MEDSHED
đ General
Croup is a common respiratory illness that affects 3% of children aged six months to three years old. Upper airway obstruction leading to swelling of larynx, trachea, and bronchi. Inflammation/swelling cause inspiratory stridor, barking cough, and hoarseness. Viral and rapid antigen tests are not recommended given their minimal impact on management
đ Oxygen
Administer for children with hypoxemia or severe respiratory distress. There are no clear benefits of humidified air inhalation and/or helium/oxygen mixtures.
đŁ Racemic epinephrine 2.25%
Arteriole vasoconstriction of upper airway mucosa, resulting in decreased edema
Associated with reduced symptom scores at 30 minutes and hospital LOS
Dose: 0.05 mL/kg racemic epinephrine 2.25% (max 5 mL)
đ Dexamethasone
Decreases laryngeal mucosal edema
Results in faster resolution of symptoms, decreases return to medical care and hospital LOS
Dose: 0.6 mg/kg (max 16 mg)
IV solution can be given orally
May administer intramuscular
đ Disposition
Observe for up to 4 hours
Consider hospitalization with no improvement in symptoms
Less than 5% of all children with croup require hospitalization; self-limiting disease
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References
Bjornson CL & Johnson DW. CMAJ. 2013 Oct 15; 185(15): 1317â1323.
Smith DK, McDermott AJ, & Sullivan JF. Am Fam Physician. 2018 May 1;97(9):575-580.
Not medical advice. Educational purposes only. No relationships to report.
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