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Croup Management - #MEDSHED

Updated: Jan 15

Welcome to the #MEDSHED! Needing a brief, concise review of clinical pharmacotherapy and disease management? Direct links of reference to content discussed? Look no further than the #MEDSHED series based on infographics and carousel presentations!


🤕 Croup Management - #MEDSHED

👋 General

Croup is a common respiratory illness that affects 3% of children aged six months to three years old. Upper airway obstruction leading to swelling of larynx, trachea, and bronchi. Inflammation/swelling cause inspiratory stridor, barking cough, and hoarseness. Viral and rapid antigen tests are not recommended given their minimal impact on management

🌐 Oxygen

Administer for children with hypoxemia or severe respiratory distress. There are no clear benefits of humidified air inhalation and/or helium/oxygen mixtures.

💣 Racemic epinephrine 2.25%

Arteriole vasoconstriction of upper airway mucosa, resulting in decreased edema

Associated with reduced symptom scores at 30 minutes and hospital LOS

Dose: 0.05 mL/kg racemic epinephrine 2.25% (max 5 mL)

💊 Dexamethasone

Decreases laryngeal mucosal edema

Results in faster resolution of symptoms, decreases return to medical care and hospital LOS

Dose: 0.6 mg/kg (max 16 mg)

IV solution can be given orally

May administer intramuscular

🌌 Disposition

Observe for up to 4 hours

Consider hospitalization with no improvement in symptoms

Less than 5% of all children with croup require hospitalization; self-limiting disease


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Bjornson CL & Johnson DW. CMAJ. 2013 Oct 15; 185(15): 1317–1323.

Smith DK, McDermott AJ, & Sullivan JF. Am Fam Physician. 2018 May 1;97(9):575-580.


Not medical advice. Educational purposes only. No relationships to report.

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