Croup / laryngotracheobronchitis (LTB)

General steps:

• Keep baby calm as crying may aggregate the condition - keep baby with mother
• Supplementation of O2 if saturation ≤ 94%

Specific measures:

Mild - occasional barking cough without audible stridor at rest

• Oral dexamethasone 0.6mg/kg stat (or) neb with budesonide 2mg
• Counsel - likely recovery in 48-72hrs, danger signs, 

Mod - severe: - frequent barking cough, stridor, retractions

• Oral dexamethasone 0.6mg/kg Max 8mg
• Neb c Adrenaline (1:1000) 0.5ml/kg (max 5ml) mixed with NS to make total upto 5ml.
• Can give repeat dose of adrenaline neb after 2hrs
• Administer O2 if sat <94%
• If symptoms subside discharge after 4 hours or else hospitalise.
• Steroids frequent doses may be needed in severe cases.