Croup

What is croup?

Croup is a viral infection of the vocal cords, voice box (larynx), and windpipe (trachea).

Symptoms of a croup include:

• a tight, low-pitched "barking" cough
• a hoarse voice

You may hear a harsh, raspy, vibrating sound when your child breathes in. This is called stridor. Stridor is usually present only with crying or coughing. As the disease becomes worse, stridor also occurs when your child is sleeping or relaxed. With severe croup, breathing may be difficult.

What is the cause?

Croup is a viral infection of the vocal cords, voice box, (larynx) and windpipe (trachea). It is usually part of a cold. Swelling of the vocal cords causes hoarseness.

Stridor occurs as the opening between the vocal cords becomes more narrow.

Why was my child admitted to the hospital?

Main complication: ________________________________________.

__ Needs medication to help ease breathing.

__ Needs a health care provider to monitor breathing.

__ Needs oxygen.

__ Other reasons: _________________________________________.

How long does it last?

Croup usually lasts for 5 to 6 days and generally gets worse at night. During this time, it can change from mild to severe many times. The worse symptoms are seen in children under 3 years of age.

What are the requirements for discharge?

• _______________________________________________________
• _______________________________________________________
• _______________________________________________________

What should I do if my child has an attack of stridor at home?

If your child suddenly develops stridor or tight breathing, do the following:

• Inhalation of warm mist

  Warm moist air seems to work best to relax the vocal cords and break the stridor. The simplest way to provide this is to have your child breathe through a warm, wet washcloth placed loosely over his nose and mouth. Another good way, if you have a humidifier (not a hot vaporizer), is to fill it with warm water and have your child breathe deeply from the stream of humidity.

• The foggy bathroom

  In the meantime, have a hot shower running with the bathroom door closed. Once the room is all fogged up, take him in there for at least 10 minutes. Try to help your child not be afraid by cuddling or reading a story.

• Results of first aid

  Most children settle down with the above treatments and then sleep peacefully through the night. If your child continues to have stridor, call your child's health care provider IMMEDIATELY. If your child turns blue, passes out, or stops breathing, call the rescue squad (911).

How can I take care of my child?

If your child has a croupy cough (without stridor), follow these guidelines:

• Humidifier

  Dry air usually makes a cough worse. Keep your child's bedroom humidified. Use a humidifier if you have one. Run it 24 hours a day. Otherwise, hang wet sheets or towels in your child's room.

• Warm fluids for coughing spasms

  Coughing spasms are often due to sticky mucus caught on the vocal cords. Warm fluids may help relax the vocal cords and loosen up the mucus. Use clear fluids (ones you can see through) such as apple juice, lemonade, or herbal tea. Give warm fluids only to children over 4 months old.

• Cough medicines

  Medicines are less helpful than either mist or drinking warm, clear fluids. Children 5 years old or older can be given cough drops for the cough. Younger children over 1 year of age can be given 1/2 to 1 teaspoon of corn syrup as needed to thin the secretions.

• Close observation

  While your child is croupy, sleep in the same room with him. Croup can be a dangerous disease.

• Smoke exposure

  By all means, don't let anyone smoke around your child. Smoke can make croup worse.

• Contagiousness

  The viruses that cause croup are quite contagious until the fever is gone or at least during the first 3 days of illness. Since spread of this infection can't be prevented, your child can return to school or child care once he feels better.

• Other medicines

  For pain or fever over 102°F (39°C) give ________________________

  _________________________________________________________

  _________________________________________________________

• Additional instructions

  _________________________________________________________

  _________________________________________________________

  _________________________________________________________

  _________________________________________________________

When does my child need to be seen again?

___ Your child needs to be rechecked and has an appointment on _____________ at _______ with _________________________.

___ Your child needs to be rechecked in ________ days. Call your child's doctor to make an appointment.

___ A follow-up appointment is not necessary. Call the doctor if you have any concerns.

When should I call my child's health care provider?

Call IMMEDIATELY if:

• Breathing becomes difficult (when your child is not coughing).
• Stridor returns and the warm mist fails to clear up it up in 20 minutes.
• Your child starts acting very sick.

Call within 24 hours if:

• Croup lasts more than 10 days.
• You have other concerns or questions.