If child is <6 months think: laryngomalacia and
if >6y-3y/o think croup
- The differential of child with stridor <6m:
- laryngomalacia
- vocal cord paralysis
- subglottic stenosis
- vascular ring structures
- Other causes of stridor: tracheitis, epiglottitis, trauma, foreign body, deep neck space infection
- Tips for the treatment of croup:
- Dexmethasone is superior to prednisolone. Start dexmethasone at 0.15-0.6 mgkg. Typically one time dosing is sufficient. PO/IM forms are considered equivalent.
- A 2011 Cochrane review found no difference in the type of nebulized epinephrine used.
- If regular epinephrine dosing is 0.5 ml/kg of 1:1000. If 2.25% racemic epinephrine, give 0.05 ml/kg
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