Croup
Alternate Names : Acute Laryngotracheobronchitis
What are the treatments for the infection?
Since croup is usually caused by a viral infection, antibiotics are not helpful
in treating the infection. Relieving the swelling and respiratory distress are
most helpful.
For milder cases, a cool mist vaporizer should be placed near the child's
bed. This may help
reduce the cough and airway irritation.
For the child who awakens at night coughing and in distress, the best
thing to do is to steam
up the bathroom. This can be done by running hot water in the shower. Parents
should then have the
child sit in the bathroom breathing in the steam. Parents should stay with the
child until he or she
becomes calm.
Another treatment is to bundle the child up and sit outside in the cold
night air for a while. This seems to relieve the airway swelling and ease the
child's distress.
Once a child has settled down, he or she should be put back to bed with
a vaporizer near the bed.
The child should have some relief from the above measures in about 10 to 15
minutes. If he or she is experiencing an alarming degree of respiratory
distress, the emergency medical
system should be contacted.
Emergency room treatment usually consists of giving the child oxygen, a special form of
epinephrine that is inhaled, and possibly an injection of a steroid called
dexamethasone. If the child does not respond to these measures, he or she will
be admitted to the hospital.
Once admitted, the child is usually placed in a mist tent with added oxygen.
Children will then have their blood oxygen saturation level monitored. This is
the amount of oxygen that is carried in the child's bloodstream. The child will
be given frequent doses of the inhaled form of epinephrine and will be watched
very closely for any changes in breathing. In rare cases, a child may need to have a
breathing tube inserted. This provides an adequate airway for several days
until the airway swelling goes down.
What are the side effects of the treatments?
Epinephrine can cause a temporary rapid heartbeat. A single
injection of dexamethasone does not have any significant side effects. A child
who requires intubation could have some vocal cord damage or airway scarring.
This may be temporary or permanent.
What happens after treatment for the infection?
There is no special treatment needed after the
child recovers from an episode of croup.
How is the infection monitored?
Younger children with a tendency to develop croup should be watched closely for
early signs of croup whenever they develop signs and symptoms of an upper
respiratory infection. Any new or worsening symptoms should be reported to the
healthcare provider.
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