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Croup – severe — RACP Paediatrics MCQ

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ModerateRespiratoryCroup – severeRACP Paediatrics

A 2-year-old with severe croup has biphasic stridor at rest with marked sternal recession and appears exhausted. Dexamethasone was given 10 minutes ago. What is the most appropriate next step?

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Correct answer: E — Nebulised adrenaline 5 mL of 1:1000

Nebulised adrenaline (5 mL of 1:1000 undiluted via nebuliser) is indicated for severe croup with significant respiratory distress. It provides temporary relief within minutes. The child requires a minimum 3-hour observation period after nebulised adrenaline due to the risk of symptom recurrence.

Reference: RCH Melbourne – 2024 – Croup (Laryngotracheobronchitis) CPG