![]() Other supportive care methods that can help manage symptoms include emotional support, adequate hydration, and treatment of pain or fever with things like acetaminophen.įor some children, supportive care is enough, but clinical guidelines also support the use of oral corticosteroids in any child with croup, regardless of severity. Still, if it helps caregivers and children feel better, or like something is being done, it doesn’t hurt, he adds. “That’s traditionally what people have been told to do for croup, but the most recent studies would suggest that humidified air doesn’t do as much as we hoped it would do.” “A lot of times, kids sound bad at home, and by the time they get to the emergency department, they sound better because they were out in the cool night air,” Patrick says. For years, the advice has been to use humidified air to help manage the symptoms of croup, says Patrick, but recent research hasn’t been able to prove that this works. Supportive care is the hallmark of croup treatment and is the primary treatment at home, in most cases. Children who present simply with hoarseness or a barking cough can usually be managed at home, but those who experience stridor or difficulty breathing should be seen immediately in an urgent care center or emergency department, in most cases. ![]() If it’s a patient you know, Patrick suggests making a judgment on their individual health history and reports from caregivers. ![]() The increased use of telehealth since the COVID-19 pandemic can help in this regard, since it’s now easier than ever for pediatricians to connect visually with their patients who are at home. The first step in diagnosing croup is to assess the child’s symptoms and determine how severely the croup has presented, he says. Patrick has covered croup and several other issues in his podcast, PediaCast, a pediatric podcast for parents. In most cases, however, it’s less a matter of what is causing that croup than how bad of a case it is, says Mike Patrick, MD, an emergency medicine and general practice pediatrician at Nationwide Children’s Hospital in Columbus, Ohio. Croup is mostly diagnosed by clinical symptoms, although infection with a particular virus or bacteria can be confirmed with lab testing. However, there’s no definitive test to diagnose croup. The sudden onset and loud nature of a croup cough can be concerning, especially now, when concern for COVID-19 variants are at an all-time high. The illness usually peaks in 24 to 48 hours, resolving in about a week, in most cases. Symptoms often get worse at night, especially when a child is emotionally distressed by their symptoms. Up to 5% of all children with severe croup may end up hospitalized, but only between 1% and 3% ever require intubation. In severe cases, croup can lead to stridor and hypoxia. Most cases (85%) are mild, but about 1% end up severe. Less often, bacterial infections like Mycoplasma pneumonia and Corynebacterium diphtheria may also result in croup. 2 The most common viral causes of croup are 2: The condition is most common in the fall and winter, and viruses are to blame for 80% of cases. Here is the latest guidance for managing croup, and how to differentiate this condition from other respiratory illnesses.Ĭroup is a respiratory condition based on clinical findings, such as hoarseness, a barking cough, or stridor. However, the COVID-19 pandemic has increased awareness-and paranoia-surrounding respiratory infections. Although the management of many diseases has evolved over the years, not much has changed when it comes to croup. Upper airway obstruction-caused by inflammation and swelling in the larynx, trachea, and bronchi-creates a loud “barking” cough that is a tell-tale sign of croup. 1 Although many cases of cough involve the upper airway and are caused by viruses, they are not all the same in terms of severity. Cough is one of the most common complaints brought to the pediatric practice, resulting in nearly 30 million outpatient visits each year.
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