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Croup - Management
Who should I admit?
- Rarely, serious diseases may present with respiratory distress and stridor. Arrange immediate admission to hospital if you suspect a serious disorder:
- Caused by infection: epiglottitis, bacterial tracheitis, peritonsillar abscess, retropharyngeal abscess, or laryngeal diphtheria.
- Not caused by infection: foreign body, angioneurotic oedema, hypocalcaemic tetany, or ingestion of corrosives.
- Immediately admit a child who has moderate or severe croup, or impending respiratory failure.
- Most children will have mild croup, which can be managed at home. However, consider admission to hospital if any of the following are present. The child:
- Has a history of severe obstruction, or previous severe croup, or known structural upper airways abnormalities (e.g. laryngomalacia, tracheomalacia, vascular ring, Down's syndrome); these increase the risk of severe croup developing.
- Is less than 6 months of age.
- Is immunocompromised.
- Has inadequate fluid intake, or is refusing liquids.
- Has a poor response to initial treatment.
- Has an uncertain diagnosis.
- Or if there is significant parental anxiety, late evening or night-time presentation, the child's home is a long way from the hospital, or the parents have no transport.
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