In most cases, croup can be treated at home. Treatment with cool mist may help symptoms. Cool mist therapy may be delivered by placing a vaporizer or humidifier in the child's bedroom. If you use a vaporizer or humidifier remember to clean it following the manufacturer's instructions. Another option may be to run the shower or tub water in the bathroom with the door closed for fifteen minutes or so. Then sit in the bathroom with your child. These techniques create an environment high in humidity to help symptoms.
In addition to cool mist therapy, the child should receive adequate rest and drink plenty of fluids. Because crying can increase croup symptoms, care should be taken to comfort and soothe the child.
Finally, it is very important to closely monitor the child with croup. Talk with your doctor if your child has symptoms of croup to see if your child should be seen. Parents should be aware of symptoms of worsening croup.
Children should be treated at the doctor's office or hospital in more severe cases of croup. The doctor's office or hospital can offer medicine, monitoring, and other treatments not available at home.
There are a number of medicines that may be used when a child is seen in the doctor's office or hospital. They include:
Corticosteroids can decrease swelling in the throat and windpipe to improve symptoms of croup. Corticosteroids may be given as a pill, liquid or as a shot. They may also be given as an inhaled treatment.
Racemic epinephrine can also decrease swelling briefly. Racemic epinephrine is given in an inhaled treatment.
(Used only when concerned about bacterial infections) Antibiotics might not be used, because croup is often a viral infection. If your doctor is concerned about a bacterial cause, antibiotics may be prescribed.
- Tamiflu (Oseltamivir): Used for influenza (suspected if child has fever and cough). Influenza may be suspected if it is present in the community.
In addition to medicines, your child can be monitored closely in the doctor's office or the hospital. Doctors and nurses can ensure the child is breathing well and receiving enough oxygen and fluids. This is important in more severe cases of croup.
The HIB vaccine is given routinely. This vaccine is helpful in preventing a number of illnesses. One illness is epiglottitis, which is a severe, often lethal form of illness, with some resemblance to croup. You should inform your doctor if your child has not received this vaccination and has symptoms like those described above.
These could indicate epiglottitis or bacterial tracheitis, true medical emergencies, or impending respiratory failure, or a combination of these. Any of these complications requires immediate medical evaluation and may require treatment by a physician skilled in pediatric intubation (that is, a pediatric anesthesiologist, ENT specialist or pulmonologist), preferably in an experienced pediatric emergency center.
- Very high fever (103-104 degrees F or higher)
- Drooling (inability to swallow)
- Extremely labored breathing
- Cyanosis (blue color) or pallor
- Lethargy or loss of consciousness