Croup is a common condition in children from 6 months to 6 years of age caused by a viral pathogen, resulting in inflammation of larynx, trachea and main bronchus.
For diagnosis and management of acute croup please refer to the Royal Children's Hospital Clinical Practice Guidelines.
- Croup is caused by viruses, not bacteria
- For children outside the typical age range of 6 months to 6 years, consider alternative diagnoses more readily
- Extensive clinical examination, including tongue depressors to evaluate the tonsils, is often unnecessary in croup, and will only lead to increased distress and worsening of symptoms
- Croup does not cause hypoxia unless the child is in a state of pre-arrest due to critical airway obstruction
- Humification devices have minimal role in the management of croup
- There is no role for antibiotics, oxygen, cough medicines or other over-the-counter preparations in the management of croup
- If stridor persists despite initial management with nebulised adrenaline and steroids, always admit as this implies a critically narrowed airway.
- Not appropriate for outpatient referral for acute croup
- Consider referral to Paediatric outpatient services for recurrent severe croup only.