Croup is a childhood illness that can cause distress to children, especially at night. It is characterized by stridor and a barking cough. This viral condition results in laryngeal and tracheal swelling.
Although most cases of croup are successfully managed at home, there are still cases where medical treatments are needed to improve its symptoms. Some cases may need hospitalization and intubation for them to get better. Croup can be serious and become life-threatening as the child suffers from noisy and labored breathing, as well as inward pulling of the chest wall.
Croup accounts for 15 percent of all the pediatric respiratory infections seen in emergency rooms and clinics with viral infections as the most common cause of croup. Stridor or noisy breathing is the result of swelling on the trachea (also known as windpipe), which is the level just below the larynx (also called as the voice box).
Symptoms of Croup
The other symptoms of croup are sore throat, hoarseness of voice, and a runny nose. Flu-like symptoms such as loss of appetite, fever, feeling unwell, and general body aches may also be present. The symptoms of croup are particularly worse at night.
Croup causes obstruction of the airway; thus, it is important that the child remains calm as possible. Crying and agitation can make the obstruction of the airway worse. Comforting the child is one of the best methods to avoid worsening the child’s condition.
The Use of Epinephrine
A lot of studies have been made with regards to the effectiveness of epinephrine for the treatment of croup in children, and the results were all good. Epinephrine has been used to treat croup to relieve its symptoms quickly. This practice has been done for more than thirty years now.
Corticosteroids reduce the amount of swelling on the airway, but this type of medication usually requires at least one hour to start acting. The corticosteroids are given to children either orally or intravenously. On the other hand, inhaled epinephrine acts in as fast as 30 minutes. Thus, epinephrine administered through a nebulizer is often co-administered with corticosteroids for a much quicker relief. However, based on the results of various studies about the efficacy of epinephrine, the effects have disappeared after two hours.
Nebulized epinephrine is often given to a child with croup that has more severe swelling. This treatment technique causes a temporary reduction in the area of the trachea that’s swollen, which in turn minimizes the child’s effort when breathing. This procedure not only produces relief in the child but to the parents as well since they can now see their child a little bit well compared before.
After the administration of epinephrine, the child should still stay a little longer for further observation even if improvements with the child’s condition has been seen. Doing so helps determine how the child is doing as the effects start to wane.
Nebulized epinephrine is only given in medical facilities. It is not safe and appropriate to use at home because the child needs to be monitored by a healthcare professional upon the administration of the drug. Most importantly, the treatment may involve some risks of serious side effects such as cardiac toxicity when administered repeatedly.