Croup Flashcards
What is croup?
Croup (laryngotracheobronchitis) is an acute inflammation and obstruction of the respiratory tract of young children, affecting the larynx, trachea and bronchi. It is usually caused by a viral infection (Oxford Concise Colour Medical Dictionary, 2010). Initially, patients with croup can present with cold type symptoms and mild fever followed several days later by onset of barky cough, stridor and DIB. The cough and respiratory distress are often worse at night. Although croup is usually a mild disease, severe respiratory distress and failure can occur (Caroline, 2013).
What is the epidemiology of croup?
Occurs mostly in autumn and early winter.
Up to 3 year of age. The highest incidence of the disease occurs at around two years of age
M:F ratio 3;2 (Jokonya,2012.
What is the aetiology of croup?
Spread by droplet nucei (Jokonya, 2012) There are several viruses that are thought to be responsible for croup. However, most cases of croup result from a parainfluenza virus infection (Bjornson and Johnson, 2008). Other viruses that can be responsible for croup include adeno-virus, influenza and respiratory syncytial virus. The infection is spread by respiratory secretions (Caroline, 2013).
What is the pathophysiology of croup?
Croup particularly affects the sub-glottic space causing oedema and inflammation. The resulting disruption and restriction of the airflow causes the characteristic stridor and barking cough. In most instances, croup is a mild, self-limiting disease. Unfortunately, because the sub-glottic space is the narrowest part of a child’s airway, significant oedema and inflammation can lead to severe respiratory distress and even failure (Caroline, 2013).
Why is croup relevant to ambulance staff?
Croup is a common but usually mild disease that seldom requires intervention from ambulance personnel. However, the disease has the potential to deteriorate rapidly. Given the vulnerability of a child’s narrow airway to occlusion and their very limited tolerance of hypoxia, time-critical intervention may be required. As stated above, this will involve transportation to further care, possible use of steroids, ventilation assistance and airway adjuncts in severe cases. Treatment would be transport to hospital with the child finding their own optimal position to help their breathing - upright - in tripod position supported on parents lap if appropriate, keeping them calm. Moderate to severe croup - modified taussig score - benefit from early steroid use. Dexamethasone - oral. 4 mg =>18 months. 2 mg =
