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Croup, a common respiratory condition in children characterized by a distinctive seal-like barking cough and varying degrees of breathing difficulty, requires careful assessment and management. The severity of croup can range from mild cases with minimal symptoms to severe cases that may lead to impending respiratory failure.
Guided by NHS and British National Formulary (BNF) recommendations, this concise table outlines a tiered approach to managing croup, emphasizing the importance of symptom severity in determining the appropriate treatment and care setting. It highlights key clinical signs and provides tailored management strategies, ranging from outpatient observation for mild cases to urgent advanced airway management in severe cases, integrating the use of corticosteroids and nebulised adrenaline/epinephrine as needed.
| Severity Level | Symptoms and Signs | Management Guidance |
|---|---|---|
| Mild Croup | • Seal-like barking cough. • No stridor at rest. • No sternal/intercostal recession at rest. | • Outpatient management. • Single dose of oral corticosteroid (e.g., dexamethasone) may be beneficial. |
| Moderate Croup | • Seal-like barking cough. • Stridor at rest. • Sternal recession present. • No or little agitation or lethargy. | ♦ Consideration for hospital admission. ♦ Steroid treatment and observation. ♦ Oral corticosteroid (e.g., dexamethasone or prednisolone); alternatives if oral intake is not feasible. |
| Severe Croup... |
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