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Paediatric croup with exhaustion — DipIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesPaediatric croup with exhaustionDipIMC

A 2-year-old has barking cough and stridor at rest. He is drooling minimally but alert, SpO2 92% on air, has marked recession and becomes quieter during transfer preparation. What is the most appropriate drug/dose?

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Correct answer: C — Nebulised adrenaline with urgent hospital transfer

Severe croup with stridor at rest and fatigue needs minimal handling, oxygen if tolerated, nebulised adrenaline and urgent transfer. Throat examination can precipitate complete obstruction, especially if epiglottitis is in the differential. Salbutamol treats lower airway bronchospasm rather than upper airway oedema.

Reference: JRCALC Guidelines; NICE croup principles