Croup childhood Flashcards
Croup
what about it
Common, acute respiratory illness
Gradual onset, typically mild and self-limiting
Most often seen in children aged 6/12 – 6 years
Occurs all year round
Peaks in spring & autumn
Often worse at night
Is the commonest cause of stridor
95% are due to viral illness
Parainfluenza virus most common cause, also RSV & influenza
Stridor, hoarseness, barking ‘seal like’ cough result from inflammation and narrowing around the subglottic region
Frightening experience for parents
Other causes for stridor: epiglottitis
Bacterial tacheitis, FB, abcesses, anaphylaxis etc.
Signs & Symptoms
Viral croup
Onset over a few days Preceding cold symptoms Stridor only when upset Stridor sounds harsh Voice harsh Barking cough Unwell: temp < 38.5°C Can swallow oral secretions
Signs & Symptoms
Epiglottitis
Sudden onset No preceding viral illness Continuous stridor Stridor softer (snoring) Voice muffled / whispering Cough not prominent Toxic, very ill: temp 390C Drooling of secretions
Differences between the two – croup
Differences between the two – croup noisy
Epi – quieter, look more unwell, toxic
Epiglottitis not often seen in children now due to HIB immunisation. Good comparisom.
coup Assessment
Hands off approach!
Observe:
Respiratory rate, grunting, recessions, colour, accessory muscle use, stridor
Engagability with carer: tiredness, agitation, drowsiness, lethargy, altered mental state
Oxygen saturations
Croup score
tools for croup
Modified Taussig Croup Score
croup Management child
Hands off, calm approach
Keep child in position of comfort
Avoid: examination of the throat, blood sugar measurement, nebulisers etc
Refer to appropriate facility for further treatment and management