Acute Severe Croup

1) if severe croup call paediatrics and anaesthetics early

2) Consider nebulised budesonide 0.5mg-1.0mg /2ml (cover eyes while giving)

3) Do not look in throat if needing tongue depressor for same, leave child in parent's arms if it helps calm child

4) if no dexamethasone possible, may give Prednisolone 2mg/kg orally as stat dose. If IV in situ give hydrocortisone IV 4mg/kg (max dose 100mg)

3) cannula attempt may, or may not be needed (ED/Paeds/Anaesthetics to form consensus plan

4) safest intubation technique is usually in theatres with "light" inhalational anaesthetic and ENT present for difficult airway.