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Croup — RACP Paediatrics MCQ

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EasyRespiratoryCroupRACP Paediatrics

A 2-year-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 97% 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 if stridor persists

Moderate croup is a clinical diagnosis and is treated with corticosteroid; nebulised adrenaline is added for persistent or worsening stridor and work of breathing. Imaging can distress the child and is not indicated in typical croup without features of bacterial tracheitis or epiglottitis. The pearl is to minimise distress while treating the airway obstruction.

Reference: RCH Clinical Practice Guidelines: Croup; Therapeutic Guidelines (eTG)