Difference between Epiglottitis and Croup
Laryngotracheobronchitis or Croup
Croup is an infectious illness of the respiratory system which is described as the inflammation of the larynx, trachea and major bronchi. It is one of the most frightening diseases of early childhood for both parents and children.
- The inflammation with laryngotracheobronchitis or croup occurs most frequently in children between 6 months and 3 years of age.
Signs and Symptoms
The signs and symptoms of croup become worst at night. At nighttime, children are crying and upset making the symptoms worst. The viruses that cause this disease result to the inflammation of the airway and later on affect the bronchi. The following are the clinical manifestations noted in children with croup:
- Temperature mildly elevated
- Only a mild upper respiratory tract infection at bedtime is present but during the night they develop a barking cough (croupy cough), inspiratory stridor, and marked retractions
- Cyanosis is rarely present
The clinical symptoms often lasts 5 or 6 nights, but the first night or two are usually the most severe. Rarely, croup can last for weeks. The danger of glottal obstruction from the laryngeal inflammation is very real. Pulse oximetry and transcutaneous SO2 monitoring are helpful measures to document whether hypoxemia is occurring.
- Cool moist air helps can provide relief to children.
- To reduce inflammation and produce effective bronchodilation by opening the airway, a corticosteroid such as dexamethasone or racemic epinephrine may be given through a nebulizer.
- One emergency method at home in relieving croup symptoms is to run the shower or hot water in a bathroom until steam fills the room. The child is then kept in this warm and moist environment for at least 10 minutes,
- Cough medications are not recommended to be given to the child unless discussed with the physician.
- IV fluids are given to keep the patient well hydrated.
- Never elicit a gag reflex with a croupy cough and provide comfort when crying. Crying and eliciting a gag reflex such as by placing a tongue depressor on the client’s mouth results to laryngospasm that causes death in children with croup due to the total occlusion of the airway.
- Prepare an intubation set at the bedside for possible intubation.
- When the following clinical manifestations are noted, a need for medical attention or hospitalization is required:
- Increasing or persistent breathing difficulty
- Cyanosis or bluish discoloration of the skin
- Dehydration (poor skin turgor, dry skin)