Acute management of croup in the emergency department

Area of Science:

• Pediatrics
• Emergency Medicine
• Pharmacology

Background:

• Croup is a frequent cause of upper airway obstruction in children.
• Symptoms include barky cough, hoarse voice, stridor, and respiratory distress due to viral-induced inflammation.
• Steroids are recommended for all children with croup presenting to the emergency department.

Purpose of the Study:

• To discuss the evidence-based management of typical croup in the emergency department.
• To highlight the efficacy of steroids in treating croup symptoms.
• To address practice variations in croup management.

Main Methods:

• Review of published guidelines for croup diagnosis and treatment.
• Discussion of the evidence supporting steroid use.
• Analysis of practice variations in emergency departments.

Main Results:

• Dexamethasone (0.6 mg/kg orally) is a highly effective single-dose treatment for croup.
• Steroids are considered the cornerstone of croup management.
• Significant variability exists in physician practices for treating croup in the ED.

Conclusions:

• Evidence supports steroids as the primary treatment for croup.
• Standardizing emergency department management of croup is necessary.
• Further education may reduce practice variations.