Croup Flashcards
What causes croup?
Parainfluenza virus
What does a croup cough sound like?
Seal bark like
Seals sit in groups and sound like CROUP
What does croup cause?
Inflammation and swelling of the upper airway
Who does croup affect?
6m-2 year old
male>female
Prognosis for croup
Self resolving but can cause respiratory failure
Epidemiology
6m to 6years, peak incidence years 1-2
Pathophysiology
Parainfluenza virus, causing inflammation and swelling of the larynx and trachea
Symptoms
Coryzal symptoms
Hoarseness of voice due to vocal cord inflammation
Seal like cough - worse at night
Harsh stridor
Resp distress
Scoring system for croup
Westley score
What do each of the scores mean?
Mild - cough without stridor
Moderate - cough with stridor and sternal recession but no lethargy
Severe - lethargic child
What do each of the scores mean?
Mild - cough without stridor
Moderate - cough with stridor and sternal recession but no lethargy
Severe - lethargic child
Signs of impending respiratory failure
Pallor
Asynchronous breathing
Increasing upper airway obstruction
Fatigue
Cyanosis
Reduced consciousness
When do you admit a child with croup?
All children who have a moderate or severe croup
Children with mild croup if they have:
- Downs
- immunodeficiency
- less than 6m old
- chronic lung disease
- inadequate food intake
- resp rate over 70
Management
Mild - PO dex 0.15mg/kg, can repeat up to 0.6mg/kg + paracetamol
Moderate - Dex or nebulised steroids
Severe - dex and adrenaline plus oxygen via a non rebreathe mask
