Croup Pediatric Care Plan

By David Shafran, MD
Medically reviewed
January 18, 2021

What is Croup?

Croup is in an infection that causes swelling of the area surrounding the vocal cords. It is most common in children under the age of 5 years old.

Croup is a viral condition, most commonly caused by the parainfluenza virus.

The most common symptom of croup is a ‘barky’ cough. Other symptoms can include:

  • Stridor, a harsh vibrating sound when breathing, caused by inflammation of the airway.
  • Hoarseness
  • Fever
  • Runny nose

Stridor is the most dangerous symptom associated with croup. Inflammation of the upper airway can make it harder for your child to breathe.

Stridor occurs when the skin at the bottom of the neck just above the sternum indents inwards when your child tries to breath in, indicating that inspiration is labored. Stridor can become more pronounced when your child is agitated or has a fever.

Croup Diagnosis & Treatment

Diagnosis of croup can be made by taking a history and doing a physical examination. Sometimes, an x-ray might be done to look at narrowing in the upper airways.

Treatment of croup depends on the severity of symptoms. 

For a child with no stridor when calm, or very mild stridor, and no difficulty breathing:

Croup can be managed from home, as long as you are in communication with your child’s medical provider. Treatment includes:

  • Oral Steroids
  • Bathroom filled with steam
  • Cold, nighttime air
  • Tylenol and ibuprofen as needed for fevers
  • Plenty of fluids and rest

For a child with significant stridor when calm:

This requires emergency room evaluation immediately. Treatment in the emergency room might include:

  • Oral steroids
  • Nebulized epinephrine – this is a medication given through a mask that helps open the airways
  • Oxygen
  • Tylenol and ibuprofen for fevers
  • Encouraging fluid intake

In cases where a child does not improve significantly in the emergency room, they will be admitted to the hospital for further management.

Check in With K If…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a Doctor in Person If…

  • Your child is having difficulty breathing
  • Your child develops high fevers
  • Your child is not drinking well
  • Your child develops significant pain
  • Your child has drooling or difficulty swallowing
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.