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Croup, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Viral infection of the upper respiratory tract

  • Most commonly presents in children 6 mo–3 yr:

    • Laryngotracheitis/laryngotracheobronchitis

    • Inspiratory stridor owing to extrathoracic airway...

Diagnosis

Signs and Symptoms

History

  • Nonspecific upper respiratory prodrome with or without fever

  • Duration of illness

  • History of tracheal intubation

  • Possibility of foreign body aspiration

  • Previous episodes

  • H...

Treatment

Pre-Hospital

  • Allow child to maintain position of comfort.

  • Defer interventions that may distress child such as:

    • IV access

    • IM injections

  • If severe distress:

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

  • Young infants, pre-existing upper airway obstruction

  • Persistent or recurrent stridor at rest unresponsive to nebulized epinephrine, or recurring during 2–3 hr obs...

Pearls and Pitfalls

  • Beware young infants with stridor

  • High incidence of congenital abnormalities

  • Mild and early epiglottitis or bacterial tracheitis may mimic croup

Additional Reading

  • Bjornson  C, Russell  KF, Vandermeer  B, et al. Nebulized epinephrine for croup in children. Cochrane Database Syst Rev.  2011;16(2):CD006619.

  • Cherry  JD. Clinical practice. Cro...

Codes

ICD9

  • 464.4 Croup

  • 464.20 Acute laryngotracheitis without mention of obstruction

ICD10

  • J04.2 Acute laryngotracheitis

  • J05.0 Acute obstructive laryngitis [croup]

SNOMED

  • 71186008 Croup (disorder)

  • 275495004 A...

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