(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 </=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 3-6  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.