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Croup — RACP Paediatrics MCQ

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ModerateRespiratoryCroupRACP Paediatrics

A 20-month-old presents at night with barking cough, hoarse voice and inspiratory stridor at rest. He is alert but has moderate sternal recession. Oxygen saturation is 96% in air and there is no drooling. What is the most appropriate management?

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Correct answer: A — Oral dexamethasone with nebulised adrenaline and observation

Stridor at rest indicates moderate to severe croup, so corticosteroid plus nebulised adrenaline with observation is appropriate. Imaging is not needed in typical croup and should not delay treatment. Drooling, toxic appearance or tripod posture would raise concern for alternative upper-airway obstruction.

Reference: RCH Croup guideline; Therapeutic Guidelines (eTG)