Sandbox/AL

SAMPLE

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Title   ▸  Subtitle   ▸  Subtitle

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

Medical Therapy Based on the Drug

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Croup Medical Therapy   ▸  Glucocorticoids   ▸  Epinephrine   ▸  Oxygen   ▸  Mist Therapy   ▸  Antibiotics   ▸  Heliox

Glucocorticoids Mild to Moderate Croup ▸ Dexamethasone 0.60 mg/kg PO/IM/IV, single dose (max. 10 mg) OR ▸ Budesonide 2mg nebulized Severe Croup ▸ Dexamethasone 0.60 mg/kg IM/IV, single dose OR ▸ Budesonide 2mg nebulized 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 Heliox ▸ There is a short-term benefit of heliox inhalation in children with moderate to severe croup.

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

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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