Croup

Question 1

Fill in the blank:
“For severe presentations, ____________ should be your first priority treatment. ___________ can be considered. For mild to moderate presentation, only _____________ should be considered.

Answer 1

1. EPINEPHrine
2. Dexamethasone
3. Dexamethasone

Question 2

What should you attempt to do prior to initiating nebulized EPINEPHrine, if the pt.’s condition permits it?

Answer 2

Exposing them to moist, cold air

Question 3

True or false:
Only patients between the ages of 6 months to 8 years of age can be treated using the Croup Medical Directive?

Answer 3

False: If the indications are met you can patch to BHP and ask for permission to treat a patient who’s age is greater than outlined age for this directive.

Question 4

Fill in the blank:
“When treating with Dexamethasone, the contraindication to steroids only applies to _________ steroids (PO, parenteral) and not inhaled or topical steroids.”

Answer 4

systemic

Question 5

True or false:
Inhaled steroids are very specific to lung tissue and do not contribute to systemic absorption.

Answer 5

True

Question 5

True or false:
If a patient has not received systemic steroids in the past 48 hours, an additional dose is likely to improve their condition due to its short half-life.

Answer 5

False: If a patient has not received systemic steroids in the past 48 hours, an additional dose is UNLIKELY to improve their condition due to its LONG half-life

Question 6

What are the required indications for the Croup Medical Directive?

Answer 6

Current history of URTI (Upper Respiratory Tract Infection) AND Barking cough or recent history of a barking cough

Question 7

What are the conditions for EPINEPHrine use in the Croup Medical Directive?

Answer 7

Age: >or= 6 months to <8 years
LOA: N/A
HR: < 200 bpm
RR: N/A
SBP: N/A
Other: Stridor at rest

Question 8

What are the contraindications for EPINEPHrine use in the Croup Medical Directive?

Answer 8

Allergy or sensitivity to EPINEPHrine

Question 9

What are the condition for Dexamethasone use in the Croup Medical Directive?

Answer 9

Age: >or = 6 months to <8 years
LOA: Unaltered
HR: N/A
RR: N/A
SBP: N/A
Other: For mild, moderate, and severe Croup

Question 10

What are the contraindications for Dexamethasone use in the Croup Medical Directive?

Answer 10

1. Allergy or sensitivity to steroids
2. Steroids received within the last 48 hours
3. Unable to tolerate oral medications

Question 11

EPINEPHrine:
For a weight of < 10 kg, and a route of NEB………what is the dose, max. single dose, dosing interval, and max. # of doses you could administer?

Answer 11

Dose: 2.5 mg
Max. Single Dose: 2.5 mg
Dosing Interval: N/A
Max. # of Doses: 1

Question 12

EPINEPHrine:
For a weight of >or = 10 kg, and a route of NED……what is the dose, max. single dose, dosing interval, and max. # of doses you could administer?

Answer 12

Dose: 5 mg
Max. Single Dose: 5 mg
Dosing Interval: N/A
Max. # of Doses: 1

Question 13

Dexamethasone:
For the ages of >or= 6 months to < 8 years, and a route of PO………what is the dose, max. single dose, dosing interval, and max. # of doses you could administer?

Answer 13

Dose: 0.5 mg/kg
Max. Single Dose: 8 mg (3 years+ = the full dose)
Dosing Interval: N/A
Max. # of Doses: 1