الخانوق

Definition

Croup is a viral infection (usually parainfluenza) causing swelling of the larynx and trachea below the vocal cords, mostly between 6 months and 3 years.

Symptoms

• Coryza and mild fever, then a barking cough
• Inspiratory stridor and hoarseness
• Worse at night

Severity signs

Stridor at rest, chest recession, agitation or drowsiness, low saturation.

Treatment

• Dexamethasone, a single dose for almost all cases
• Nebulised adrenaline for moderate or severe croup, with hours of observation because it wears off
• Oxygen if needed
• Keep the child calm on a parent’s lap

Nursing care

• Monitor breathing, stridor and saturation
• Avoid distressing the child, as crying worsens obstruction
• Teach parents when to return

Versus epiglottitis

Croup is gradual with a barking cough and low fever. Epiglottitis is sudden with high fever, drooling and no cough, and the throat is not examined.

Exam point

After nebulised adrenaline the child is observed for some hours for rebound symptoms.