Croup, a common viral condition, causes swelling in a child’s airway, making it hard to breathe. This is because the already-narrow airway is made even narrower. This viral infection often starts as a common cold, which is then followed by a harsh, barking sound, especially at night. It is also worse when the air is cooler.
Croup commonly affects children below five years of age. In some instances, croup reoccurs and will be experienced several times.
The signs and symptoms of croup include a hoarse voice, noisy breathing (also called stridor), and a harsh, barking cough. The symptoms may last for 3 to 4 days. Croup may also be accompanied by flu-like symptoms, such as a cough and a runny nose.
A diagnosis of croup is easily made through physical examination, description of symptoms, and auscultation of the chest. Laboratory procedures are not necessary but may be indicated in severe cases.
Most cases of croup are mild and can be treated at home effectively. Home treatments may include making the child calm and relaxed, keeping them hydrated, and giving them over-the-counter medications for pain and fever. If the symptoms are not settling through home treatments, your child needs medical attention.
Steroids are given by doctors to help reduce inflammation and swelling. It can also help lessen the duration of croup episodes. Steroids may be taken either orally or inhaled. A single dose of an oral corticosteroid, such as prednisolone or dexamethasone, is usually given.
When steroids are effective for a child with croup, there is no more need for the child to be admitted to the hospital. Some side effects of steroids may include vomiting, restlessness, headache and upset stomach.
Painkillers like paracetamol and ibuprofen can be given to children. These medications are available in liquid form and can be bought over the counter. Painkillers help in managing discomfort while the child has croup, and can also help decrease the body’s temperature if the child has a fever.
Decongestants or cough medicines are not advisable to be taken when a child has croup, as these medications do not help alleviate the symptoms of croup. These can make a child drowsy during treatment, and thus, it can be harmful when a child has breathing problems during an attack of croup.
For severe cases of croup, adrenaline may be given during admission. Adrenaline reducing the swelling in the airway until the steroids can work. It is administered through a nebulizer. During treatment, a mist of air is formed, which is then inhaled. Symptoms are expected to improve within 10 to 30 minutes, and the effects last for 2 hours.
If the child is really having difficulty breathing, oxygen may be given to assist.
In rare cases, intubation may be performed. The procedure is indicated when the airway obstruction is not managed by conservative treatment, and the child’s situation continues to worsen. Intubation involves inserting a tube in the nostril or the mouth and passed down to the windpipe. This technique is performed under general anesthesia. Intubation will help the child breathe more easily.
Antibiotics are not recommended for croup unless there is a secondary bacterial infection.