Hello Caregivers, many of you have written in to ask for information about cough & cold. Although most upper respiratory tract infections are mild, there are some emergencies. Let’s talk about croup.
We’ll discuss the facts about croup. Upon discharge from the Children’s Emergency, how can parents manage this condition at home? Most importantly what are the red flags?
What Is Croup And Who Gets It?
Croup is a viral infection of the vocal cords, voice box & wind pipe. The swelling in this area creates a peculiar sounds when breathing in, and a barking quality to the cough. To listen to what this sounds like, watch this one-minute-long video I made: https://youtu.be/2JjxmUoNJ2g.
Generally, it affects young children, particularly under three years old. It is especially worse at night, probably when the air is colder and drier.
How Do Doctors Treat Croup In The Hospital?
Since croup is a viral infection, affected children do not need antibiotics. Instead they receive steroids to treat the inflammation causing the swelling. The dose and route of delivery depends on the severity of the croup. For instance, if the child only has stridor when provoked but is otherwise breathing calmly and cheerful, his illness is mild. However, if he has stridor even at rest, uses extra muscles to breathe, or appears blue from lack of oxygen, then things are serious. He might need more medication like adrenaline or equipment to help him breathe.
How Can Parents Manage Croup At Home?
Often, the child is well enough to be sent home, perhaps after a single dose of steroids in hospital and two hours of observation. If you have a minute, watch this video and take note of these measures: https://youtu.be/1Basg6tvvaM.
Essentially, no antibiotics are required. Medication like promethazine helps to reduce cough for children over two years old. Parents should make sure their children get lots of warm, clear fluids. It’s prudent to avoid exposure to smoke which can be an irritant. Some parents choose to monitor their child’s breathing by sleeping in the same room as them at night while others use a monitor. If you feel like things are getting worse, do not hesitate to return to the hospital for further assessment.
When Do Parents Need To Be Alarmed?
Red flags include the child feeding poorly, because when they can’t breathe well, they can’t feed well. Sometimes it is obvious that he has difficulty breathing. You may notice he breathes very fast and may have heaving muscles around his chest. If the child appears pale or blue, that could suggest there is not enough oxygen in his system. If the illness is unusually long, say more than a week, he should be looked at again.
You can view these red flags summarised into one minute: https://youtu.be/JLFJaSdY93g.
This week I have a student intern whom I met at So You Want To Be A Doctor. Under supervision, my student intern discussed these one-minute-long croup videos with parents. Thankfully, their response to the videos was good and they were so kind to my student. In fact, she got to meet other members of my team, including a young doctor, my nurse and my porters. I’m glad she got a taste of what it’s like to be a doctor in front-line medicine, working with a team. As caregivers looking after the children we discharge, you’re part of the team too!
Thank you for writing in. Let me know if there are other topics you’d like to be discussed. Have an awesome week!