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Azza Elghonaimy
Spasmodic Croup :
Toxic No Yes
Adrenaline :
•Nebulised Adrenaline(2mg STAT) Adrenalin 5mls of 1:1000.
• 0.4mg/kg Max 5 mg .
•It is very effective in severe cases when intubation is considered.
•It reduces mucosal oedema.
•Duration of action is between 20 minutes and 3 hours.
•Contraindicated in Fallots Tetralogy (Ventricular outflow obstruction)
Steroids:
Dose :(0.15mg/kg)
Oral Dexamethasone OR Nebulised adrenaline.
Intubation :
•Severe cases with worsening airway obstruction
with signs of
•exhaustion or impending respiratory failure .
If a child has croup that is severe or might cause complications then the
child can be given either oral prednisolone 1-2mg/kg or oral
dexamethasone (2mg/5mL oral solution) 150micrograms/kg,
before transfer to hospital .
Worrying signs in children with stridor :
•High fever or signs of toxicity.
•Rapid onset .
•Drooling and dysphagia.
•Muffield voice and quiet stridor.
•Angioedema
•Age less than 4 months.
•Skin cavernous haemangioma.
•Previous ventilation as a neonate
References:
•MRCPCH Mastercourse.
•GP notebook.
•Oxford handbook of Paediatrics
•Local hospital guidelines
Thank you
Any question