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Severe croup — DipIMC MCQ

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EasyPaediatric and Obstetric EmergenciesSevere croupDipIMC

A 2-year-old has a barking cough, stridor at rest and intercostal recession at home. He is anxious, oxygen saturations are 91% and temperature is 38.2°C. What is the most appropriate drug/dose?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Nebulised adrenaline with corticosteroid and urgent transfer

Stridor at rest with recession suggests severe croup, where nebulised adrenaline and corticosteroid are appropriate with urgent transfer. Throat examination can worsen upper-airway obstruction and should be avoided in a distressed child. Salbutamol treats lower-airway bronchospasm rather than croup. The pearl is to keep upper-airway children calm and avoid unnecessary procedures.

Reference: JRCALC Guidelines 2025; NICE CKS Croup