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This guideline has been designed to assist in the diagnosis and management of children with croup. It includes a management algorithm and a list of potential differential diagnoses.
Children presenting with the signs of croup.
Healthcare professionals involved in acute paediatric medicine.
Croup is an acute respiratory illness causing inflammation and narrowing of the subglottic region of the larynx. It is most often caused by a viral infection.
Where appropriate (if severity allows) a minimally invasive HANDS OFF APPROACH allows best initial assessment– as children can look very different if allowed to settle for a few minutes
Do not examine throat
If hypoxic try to give O2 by facemask
The following clinical signs (in varying combination) are found in croup:
|Haemophilus influenzae B|
|6m - 3yr||Any age||2 - 6 yr|
|Barking cough, stridor||Barking cough, stridor||Muffled, gutteral cough|
|Normal||Difficult||Very difficult with drooling|
|Normal||Anxious||Anxious, distressed, toxaemic|
Last reviewed: 24 February 2017
Next review: 31 March 2019
Author(s): Steve Foster
Approved By: Clinical Effectiveness
Reviewer Name(s): ED Department