(Hypoxia is a late sign in croup as this reflects gas exchange at the alveolar level, while the disease in croup involves the airway. Thus,measuring oxygen saturations is of no clinical benefit.)
Score 0-2 (mild croup)
Rx Single dose oral dexamethasone (0.15mg/kg).
(If unavailable, oral prednisolone 1-2mg/kg can be used – a rpt dose may be required at 12 hours).
Consider management at home unless other clinical concern.
Score 3-5 (mild/moderate croup)
Treat with steroids.
Admit in most cases.
With good safety netting some patients can be managed at home if,
- confident and competent parents
- child can be monitored closely
- child can be reviewed at 4 hours
- 4hr review shows significant improvement
If in doubt admit.
Score >6 (severe croup)
Admit, via ambulance. Initiate steroid treatment.