Croup Admission Information and Discharge Instructions

What is croup?

Croup is an inflammation of the vocal cords, voice box (larynx), and windpipe (trachea).

There are two kinds of croup:

• Viral croup results from a viral infection in the voice box and windpipe. This kind of croup often starts with a cold that slowly develops into a barking cough. As your child's airway swells and fluid builds up, it becomes harder for him to breathe. Most children with viral croup have a low fever, but some have temperatures up to 104°F (40°C).
• Spasmodic croup is usually caused by an allergy or an upper respiratory infection such as a cold. It often occurs suddenly in the middle of the night. Your child may go to bed with a mild cold and wake up gasping for breath. His voice will be hoarse and his cough sounds like a seal barking. Most children with spasmodic croup do not have a fever. This type of croup can occur more than once.

You may hear a harsh, raspy, vibrating sound when your child breathes in. This is called stridor. Stridor is usually present only with crying or coughing. As the disease becomes worse, stridor also occurs when your child is sleeping or relaxed. With severe croup, breathing may be difficult.

Why was my child admitted to the hospital?

Main complication: ____________________a____________________.

__ Needs medication to help ease breathing.

__ Needs a healthcare provider to monitor breathing.

__ Needs oxygen.

__ Other reasons: _________________________________________.

How long does it last?

Croup usually lasts for 5 to 6 days and generally gets worse at night. During this time, it can change from mild to severe many times. The worse symptoms are seen in children under 3 years of age.

What are the requirements for discharge?

• _______________________________________________________
• _______________________________________________________
• _______________________________________________________

How can I take care of my child?

When you get home, care for your child in the following ways:

• The foggy bathroom

  Run a hot shower with the bathroom door closed. Once the room is fogged, take him in there for at least 10 minutes. Try to help your child not be afraid by cuddling or reading a story.

• Humidifier

  Dry air usually makes a cough worse. Keep your child's bedroom humidified. Use a humidifier if you have one. Run it 24 hours a day. Otherwise, hang wet sheets or towels in your child's room.

• Warm fluids for coughing spasms

  Coughing spasms are often due to sticky mucus caught on the vocal cords. Warm fluids may help relax the vocal cords and loosen up the mucus. Use clear fluids (ones you can see through) such as apple juice, lemonade, or herbal tea. Give warm fluids only to children over 4 months old.

• Cough medicines

  Medicines are less helpful than either mist or drinking warm, clear fluids. Children 5 years old or older can be given cough drops for the cough. Younger children over 1 year of age can be given 1/2 to 1 teaspoon of corn syrup as needed to thin the secretions.

• Close observation

  While your child is croupy, sleep in the same room with him. Croup can be a dangerous disease.

• Smoke exposure

  Don't let anyone smoke around your child. Smoke can make croup worse.

• Contagiousness

  The viruses that cause croup are quite contagious until the fever is gone or at least during the first 3 days of illness. Almost all children will be infected. Since spread of this infection can't be prevented, your child can return to school or child care once he feels better.

• Other medicines

  For pain or fever over 102°F (39°C) give ________________________

  _________________________________________________________

  _________________________________________________________

• Additional instructions

  _________________________________________________________

  _________________________________________________________

  _________________________________________________________

  _________________________________________________________

When does my child need to be seen again?

___ Your child needs to be rechecked and has an appointment on _____________ at _______ with _________________________.

___ Your child needs to be rechecked in ________ days. Call your child's doctor to make an appointment.

___ A follow-up appointment is not necessary. Call the doctor if you have any concerns.

When should I call for help?

If your child turns blue, passes out, or stops breathing, call the rescue squad (911).

Call your healthcare provider IMMEDIATELY if:

• Breathing becomes difficult (when your child is not coughing).
• Stridor returns and the warm mist fails to clear up it up in 20 minutes.
• Your child starts acting very sick.

Call within 24 hours if:

• Croup lasts more than 10 days.
• You have other concerns or questions.

Written by B.D. Schmitt, MD, and Robert Brayden, MD.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.