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==Medical Therapy Based on the Severity==
==Medical Therapy Based on the Severity <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from Pediatric Pulmonology 49:421–429 (2014) <ref name="PetrocheilouTanou2014">{{cite journal|last1=Petrocheilou|first1=Argyri|last2=Tanou|first2=Kalliopi|last3=Kalampouka|first3=Efthimia|last4=Malakasioti|first4=Georgia|last5=Giannios|first5=Christos|last6=Kaditis|first6=Athanasios G.|title=Viral croup: Diagnosis and a treatment algorithm|journal=Pediatric Pulmonology|volume=49|issue=5|year=2014|pages=421–429|issn=87556863|doi=10.1002/ppul.22993}}</ref> </SMALL></SMALL></SMALL></SMALL></SMALL>==


<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL>
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL>
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! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Mild}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Mild}}
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Mild to Moderate Croup
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 0.60 mg/kg PO single dose  (max. 10 mg)''''' <br> OR <br> ▸ '''''[[Budesonide]] 2mg nebulized'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 0.60 mg/kg PO/IM/IV, single dose  (max. 10 mg)'''''
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Severe Croup
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 0.60 mg/kg PO/IV, single dose'''''|-
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! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Moderate}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Moderate}}
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Mild Croup
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Nebulized racemic epinephrine (2.25%)]] 0.05 mL/kg (max. 0.5mL) in 3mL of normal saline for 15 min''''' <br> OR <br>  ▸ '''''[[Nebulized L-epinephrine]] 0.5mL/kg (max 5mL) for 15 min'''''  <br>                ''Repeat as needed''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | There are no indications of nebulized epinephrine for Mild Croup
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Moderate to Severe Croup
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 0.60 mg/kg PO/IM single dose  (max. 10 mg)''''' <br> OR <br> ▸ '''''[[Budesonide]] 2mg nebulized'''''  
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Nebulized racemic epinephrine (2.25%)]] 0.05 mL/kg (max. 0.5mL) in 3mL of normal saline for 15 min''''' <br> OR <br>   ▸ '''''[[Nebulized L-epinephrine]] 0.5mL/kg (max 5mL) for 15 min''''' <br>                ''Repeat as needed''
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! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Severe}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Severe}}
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ Humidified oxygen should be given to patients with hypoxia or severe respiratory distress
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Nebulized racemic epinephrine (2.25%)]] 0.05 mL/kg (max. 0.5mL) in 3mL of normal saline for 15 min''''' <br> OR <br>  ▸ '''''[[Nebulized L-epinephrine]] 0.5mL/kg (max 5mL) for 15 min'''''  <br>                ''Repeat as needed''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 0.60 mg/kg IM/IV single dose  (max. 10 mg)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | AND
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ Hospital admission
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Revision as of 17:48, 21 May 2014

SAMPLE

▸ Click on the following categories to expand treatment regimens.

Title

  ▸  Subtitle

  ▸  Subtitle


Table 1
Preferred Regimen
PLUS
Alternative Regimen
Table 2
Preferred Regimen
PLUS
Alternative Regimen

Medical Therapy Based on the Drug

▸ Click on the following categories to expand treatment regimens.

Croup Medical Therapy

  ▸  Glucocorticoids

  ▸  Epinephrine

  ▸  Oxygen

  ▸  Mist Therapy

  ▸  Antibiotics

  ▸  Antitussives

Glucocorticoids
Mild to Moderate Croup
Dexamethasone 0.60 mg/kg PO/IM/IV, single dose (max. 10 mg)
Severe Croup
Dexamethasone 0.60 mg/kg PO/IV, single dose|-
Epinephrine
Mild Croup
There are no indications of nebulized epinephrine for Mild Croup
Moderate to Severe Croup
Nebulized racemic epinephrine (2.25%) 0.05 mL/kg (max. 0.5mL) in 3mL of normal saline for 15 min
OR
Nebulized L-epinephrine 0.5mL/kg (max 5mL) for 15 min
Repeat as needed
Oxygen
▸ Humidified oxygen should be given to patients with hypoxia or severe respiratory distress
Mist Therapy


Antibiotics
Antibiotic are not indicated to treat viral croup
Antibiotics are use for complications, such as bacterial tracheitis or epiglottitis


Antitussives
Preferred Regimen
PLUS
Alternative Regimen

Medical Therapy Based on the Severity Adapted from Pediatric Pulmonology 49:421–429 (2014) [1]

▸ Click on the following categories to expand treatment regimens.

Croup Medical Therapy

  ▸  Mild

  ▸  Moderate

  ▸  Severe

Mild
Dexamethasone 0.60 mg/kg PO single dose (max. 10 mg)
OR
Budesonide 2mg nebulized
Moderate
Nebulized racemic epinephrine (2.25%) 0.05 mL/kg (max. 0.5mL) in 3mL of normal saline for 15 min
OR
Nebulized L-epinephrine 0.5mL/kg (max 5mL) for 15 min
Repeat as needed
PLUS
Dexamethasone 0.60 mg/kg PO/IM single dose (max. 10 mg)
OR
Budesonide 2mg nebulized
Severe
Nebulized racemic epinephrine (2.25%) 0.05 mL/kg (max. 0.5mL) in 3mL of normal saline for 15 min
OR
Nebulized L-epinephrine 0.5mL/kg (max 5mL) for 15 min
Repeat as needed
PLUS
Dexamethasone 0.60 mg/kg IM/IV single dose (max. 10 mg)
AND
▸ Hospital admission
  1. Petrocheilou, Argyri; Tanou, Kalliopi; Kalampouka, Efthimia; Malakasioti, Georgia; Giannios, Christos; Kaditis, Athanasios G. (2014). "Viral croup: Diagnosis and a treatment algorithm". Pediatric Pulmonology. 49 (5): 421–429. doi:10.1002/ppul.22993. ISSN 8755-6863.