A2 year old child is brought to emergency at 3 AM with fever, barking cough and stridor only while crying. The child was able to drink normally. On examination respirator rate is 36/min and temprature is 39.6degC. What will be your next step ?

Ans. is b' i.e., High dose dexamethasone injection Fever, barking cough and stridor on crying in a 2 year old child suggest the diagnosis of croup. Management of Croup The main treatment for children with croup is airway management. o Treatment of respiratory distress should take priority over any testing. o Following treatment is indicated ? 1) Humidified oxygen 2) Hydration with fluids 3) Coicosteroids Are benificial in, even in mild croup. They decrease the edema in the laryngeal mucosa through their anti-inflammatory action. They reduce the need of subsequent epinephrine use. Coicosteroids used are -4 oral dexamethasone (preferred), im dexamethasone or nebulized budesonide. 4) Nebulized epinephrine Mechanism of action is believed to be constriction of precapillary aerioles through [3-receptors, causing fluid resorption from the interstitial space and a decrease in laryngeal edema. Indication for nebulized stridor are - i) Moderate to severe stridor at rest iii) Respiratory distress ii) The possible need for intubation iv) Hypoxia 5) Heliox (80% helium and 20% 02) ---> May be effective in children with severe croup who may need intubation. 6) Antibiotics are not indicated Sedatives should not be given