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Moderate to severe croup — RCPSC EM MCQ

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ModeratePaediatric emergenciesModerate to severe croupRCPSC EM

A 2-year-old has barky cough, fever, and inspiratory stridor at rest. Oxygen saturation is 95%, there is moderate indrawing, and he remains alert. He received acetaminophen before arrival. What is the most appropriate initial management?

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Correct answer: E — Nebulised epinephrine plus dexamethasone with observation

Nebulised epinephrine plus dexamethasone with observation is correct: the clues indicate Moderate to severe croup and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: PALS; Canadian Paediatric Society croup guidance