Croup

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What is croup? — “Croup” is the term doctors use for a group of infections that affect the trachea, the main airway through which we breathe. Croup is common in children between 6 months and 3 years of age. It causes a cough that sounds like a seal barking. Please visit our Clinic if you need treatment for croup.

What are the symptoms of croup? — Croup usually begins like a regular cold. Children who get croup start off by getting a runny nose and feeling stuffed up. A day or 2 later, they usually:

Get a cough that sounds like a seal barking or a frog croaking

Become hoarse (lose their voice or get a scratchy voice)

Get a fever (temperature greater than 100.4ºF or 38ºC)

Start having noisy, high-pitched breathing (called “stridor”), especially when they are active or upset

The symptoms are usually worse at night.

Should I bring my child to Dr.Paul’s Clinic? 

Call for an ambulance (in the US and Canada, dial 9-1-1) if your child:

Starts to turn blue or very pale

Has a very hard time breathing

Can’t speak or cry because he or she can’t get enough air

Is very upset

Seems very sleepy or does not seem to respond to you

If your child has above symptoms, he needs immediate medical attention. 

Your child’s cough won’t go away

Your child starts to drool or can’t swallow

Your child makes a noisy, high-pitched sound when breathing even while just sitting or resting

The skin and muscles between your child’s ribs or below your child’s ribcage look like they are caving in.

Your baby younger than 3 months has a fever (temperature greater than 100.4ºF or 38ºC)

Your child older than 3 months has a fever (temperature greater than 100.4ºF or 38ºC) for more than 3 days

Your child has symptoms of croup that last for more than 7 days

How is croup treated? — The main treatments for croup are aimed at making sure that your child is getting enough oxygen. We will give your child:

Moist air or oxygen to breathe

Medicines to reduce swelling or open up the airways

Dr.Paul Kattupalli will probably not offer antibiotics, because croup is caused by viruses, and antibiotics do not work on viruses.

Is there anything I can do on my own to help my child feel better? — Yes. You can:

Use a humidifier in your child’s bedroom, or sit in the bathroom with your child while the hot water is running in the shower

Treat your child’s fever with over-the-counter medicines, such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin). Never give aspirin  to a child younger than 18 years old.

Make sure your child gets enough fluids

If your child is older than 1 year, feed him or her warm, clear liquids to soothe the throat and to help loosen mucus.

Prop your child’s head up on pillows, if he or she is over a year old. (Do not use pillows if your child is younger than 1 year.)

Sleep in the same room as your child, so that you know right away if he or she starts having trouble breathing

Not allow anyone to smoke near your child

How did my child get croup? — Croup is caused by viruses that spread easily from person to person. These viruses live in the droplets that go into the air when a sick person coughs or sneezes.

Can croup be prevented? — You can reduce the chances that your child will get croup by:

Washing your hands and your child’s hands often with soap and water, or using alcohol hand rubs.

Staying away from other adults and children who are sick.

Making sure your child gets all the recommended vaccines, including the flu shot. Get a flu shot for yourself, too.

How does Dr.Paul’s Clinic treat Croup?

Management of children with croup begins with an assessment of severity. This can be accomplished via telephone triage or in our office. If concerns arise on telephone triage (eg, stridor at rest, an underlying airway abnormality, previous episodes of moderate to severe croup, underlying conditions that may predispose to respiratory failure, rapid progression of symptoms, inability to tolerate fluids, prolonged symptoms, or an atypical course), the child should be seen in the office or emergency department.

Management of croup is based on the severity of symptoms:

Mild croup – Children with mild symptoms (ie, no stridor at rest and no respiratory distress) we recommend supportive care. Dr.Paul might consider dexamethasone based on the symptoms and signs.

Moderate to severe croup – Children with moderate croup (ie, stridor at rest with mild to moderate retractions) should be evaluated in our office, and those with severe croup (stridor at rest with marked retractions and significant distress or agitation) should be evaluated in the emergency department. Children with severe croup must be approached cautiously, as any increase in anxiety may worsen airway obstruction.

For children with moderate to severe croup, we recommend initial treatment with nebulized epinephrine and a single dose of dexamethasone  rather than either drug alone or nonpharmacologic management.

Nebulized epinephrine  can be repeated every 15 to 20 minutes. The administration of three or more doses within a two- to three-hour time period should prompt initiation of close cardiac monitoring if this is not already underway.

If you have any questions, please call our office.

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