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Croup: a clinical examination

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Treating croup is a delicate process Distressed children and worried parents make treating croup a delicate process

Respiratory illness is a common reason for parents or care givers to access primary healthcare settings. Croup or laryngotracheobronchitis is an acute respiratory condition that causes distress and concern1.

Croup affects approximately 3% of children between the ages of 6 months and 3 years but can also be diagnosed in older children and young people, although this is less frequently observed in this age range2. The peak incidence for croup is in the 2-year age group mainly because of changes in their immunity status and the fact that they have a relatively small subglottic space1. Of this figure 6% may need hospital admission. However this is only approximate as treatment using corticosteroids and nebulised adrenaline, introduced as treatment in the 1990s, may have influenced this number3, 4.

The majority of parents and care givers therefore, are accessing healthcare services with children who have mild to moderate croup and these patients can be safely managed at home with support and guidance5. As croup is most prevalent from September to December1, admission to hospital should not always be considered as the first line of treatment, especially for children with a diagnosis of mild croup, as pressure for beds increases at this time of year.

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