What is Croup?
Common childhood URTI
What age group does Croup typically affect?
6 months – 2 years
What are the most common causes of Croup? (4 things)
- Parainfluenza (most common)
- Influenza
- Adenovirus
- RSV
What are the RF for Croup? (2 things)
- Male
- Autumn / Spring season
What are the CF of Croup? (6 things)
- Low grade fever
- Rhinorrhoea
- Barking cough
- Hoarseness
- Stridor
- Increased work of breathing
What causes the characteristic barking cough of Croup?
Impaired movement of vocal cords
What is a timing feature of the barking cough of Croup?
Occurs in clusters of coughing episodes
When are the CF of Croup worse?
@ night
What CF suggest Croup kid is in Resp distress? (2 things)
- Tachypnoea
- Intercostal recession
What are RED FLAG CF for Resp failure in Croup? (5 things)
- Drowsiness
- Lethargy
- Cyanosis
- Tachycardia
- Laboured breathing
What are some differentials that present similarly to Croup? (4 things)
- Epiglottitis
- Inhaled foreign body
- Acute anaphylaxis
- Peritonsillar abscess
How is the Dx of Croup made?
Clinically
What should you take into account before doing any investigations on a sus Croup kid?
The distress it may cause them
What imaging can you do for sus Croup and why?
CXR: To identify other causes for CF (e.g foreign body)
What invasive investigation can you do, and when should you do it?
- Direct / indirect Laryngoscopy
- Only if atypical illness / airway obst sus
How are most Croup kids managed?
At home by parents
What should you tell parents managing their Croup kid at home? (5 things)
- Symptoms usually resolve within 48 hours (upto a week)
- Croup is viral so no need 4 abx
- Use paracetamol / ibuprofen to control pain / fever
- Fluids
- Safety netting
What safety netting should you tell parents managing their Croup kid at home? (5 things)
- Seek urgent medical advice if CF worsen, aka:
- Dev intermittent stridor @ rest
- High fever
- High HR
- Resp failure signs = AMBULANCE
When should you consider admitting a Croup kid? (7 things)
- Under 6 months
- Hx of severe airway obst
- Immunocompromised
- Inadeq fluid intake
- Poor response to initial tx
- Uncertain Dx
- Parents r hella stressed
What are the Medical Mx options for Croup? (4 things)
- Oral dexamethasone (0.15mg / kg) (repeat after 12 hours PRN)
- Nebulised adrenaline (temp symptom relief)
- Keep calm (bc crying –> increases O2 demand + resp muscle fatigue)
- Oxygen
