Call 911 or go to the emergency room if your child's lips or face turns bluish, if he is working hard to breathe, cannot speak or drink, or is drooling.
In severe cases of croup, or if your child is not breathing well, your child may need to go to the hospital. You can manage most milder cases at home.
Severe croup — A child with severe croup has stridor and retractions at rest. Retractions are a sign of severe croup. These include inward movement (sucking in) of the sternum (breast bone) or skin between the ribs as the child struggles to take a breath. The child may appear anxious, agitated, or fatigued.
The inflammation is caused by a virus. Croup symptoms generally peak 2 to 3 days after the symptoms of the viral infection begin and typically last 3 to 7 days. Symptoms are worse at night and when the child is excited, exercising or crying.
Treating croup
A single dose of an oral corticosteroid medication called dexamethasone or prednisolone will usually also be prescribed to help reduce the swelling in the throat. If your child has breathing problems they may need hospital treatment, such as adrenaline and oxygen through a mask.
Nebulized epinephrine, via its alpha-1 effect of vasoconstriction, is a highly effective treatment for upper airway obstruction caused by croup. Asthma causes lower airway obstruction and is treated with albuterol whose beta-2 mechanism causes relaxation of the lower airways.
A corticosteroid — such as dexamethasone — may be given to reduce swelling in the airway. Symptoms will usually start to improve within a few hours. Your child may take pills over several days. Or your child may get a single dose of dexamethasone as a shot because of its long-lasting effects.
Croup is caused by a viral infection that leads to swelling of the lining of the airways, particularly the area just below the voice box (larynx). Croup can also be caused by other viruses, such as respiratory syncytial virus. Respiratory syncytial virus is a very common cause of... read more (RSV) or an influenza ...
Croup often begins without warning, in the middle of the night. The symptoms are often worse at night, and are at their worst on the second or third night of the illness. The signs and symptoms of croup may last for three to four days; however, a cough may linger for up to three weeks. The stridor should not persist.
Non-urgent advice: Call NHS 111 or see a GP if :
your child is getting worse. they're no better after 48 hours.
Croup is usually mild, and lasts about a week. The first two or three days are the hardest part, especially at night.
RSV does not cause a barking cough, although it may cause mild cold-like symptoms. Children with croup exhibit a high pitched, barking cough, whereas children with RSV generally have a wet and forceful cough.
Severe croup can lead to other complications, such as ear infections, respiratory distress or pneumonia. “If your child is having increasing breathing difficulties, they could be at risk for complications,” Dr. Giuliano says. “A child who's struggling to breathe should be evaluated urgently.”
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. Consider supplemental oxygen for children with severe croup and SpO2 less than 93% providing it can be administered without distressing the child.
When your pediatrician listens to your baby's lungs, if they have RSV and bronchiolitis, it actually sounds like Rice Krispies in the lungs; it's just all crackly. Quite often, pediatricians are able to get a good idea if your child has RSV or not just based on the symptoms.
Croup targets the upper respiratory tract; bronchiolitis threatens the small and medium lower respiratory tract passages. Both illnesses are associated with significant morbidity and mortality in high-risk patients. This article provides an update on the diagnosis and treatment of these 2 common pediatric diseases.
Diagnosis of croup is based on clinical findings of barking cough, stridor, and hoarseness. Diagnostic testing is typically not necessary. Humidified air inhalation does not improve symptoms in patients with moderate croup. Corticosteroids should be administered to patients with croup of any severity.
Although most cases of croup are mild, this common childhood illness can become serious and prevent your child from breathing normally. Contact your child's pediatrician if your child's croup is not improving or if you have other concerns. The doctor will make sure your child is evaluated and treated properly.
Breathing in moist air can effectively help you or your child unclog the upper respiratory as well as cure your breathing problems. If you need the immediate treatment, you can inhale the hot water from your sink in your bathroom so that your nose can be unblocked and you might breathe more easily.
Antibiotics: Since the causative organism in croup is always viral, antibiotics are generally not warranted. Children may present with bacterial superinfections such as pharyngitis or pneumonia, which do require antibiotic treatment.
If you think your child has croup, it's important to speak to a GP. They'll be able to advise on the right care and treatment. They will also check there's no other reason for the symptoms, such as something stuck in your child's throat. If your GP surgery is closed, call 111 for assistance.
Albuterol breathing treatments don't help the voice box swelling caused by croup, and hence don't make the stridor better.
Steroids given orally lessen the stridor and lessen hospitalisation. In Australia the medication is called redipred and it's dosage is about 1mg per kg given daily for three days. Note that the onset of action is 1-3 hours.