Does your child have a barking seal like cough? You better be thinking of croup! Join us on this resident-led episode today.  

This episode was written by pediatric resident Anjali Doshi and pediatricians Lidia Park and Tammy Yau with content support from Alexis Toney (UC Davis pediatric hospitalist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. 

Key points:  

• Croup, acute laryngotracheitis, a viral infection causing respiratory inflammation, bark like cough, and inspiratory stridor 
• Westley score can be used to determine severity of croup 
• Treatment for mild symptoms is humidified air and supportive care 
• Treatment for moderate/severe symptoms is racemic epinephrine breathing treatment and IV dexamethasone 
• Imaging can be considered to rule out bacterial tracheitis or epiglottitis if history and physical exam cannot narrow down the differential to croup 
• Antibacterials not normally given unless concurrent infection 



Reference: 

• AAP Point of Care Quick Reference, Retzke, 2021. https://doi.org/10.1542/aap.ppcqr.396247 
• Russell KF, Liang Y, O'Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup. Cochrane Database Syst Rev. 2011;(1):CD001955. Published 2011 Jan 19. doi:10.1002/14651858.CD001955.pub3 
• Cochrane Database Syst Rev. 2018;10:CD006822. Epub 2018 Oct 29.   
• Juliette Anderson. “Baby with Croup Stridor Barking Cough Visual & Audio Sound - When to Hospitalize.” YouTube, 14 Apr. 2011, www.youtube.com/watch?v=Qbn1Zw5CTbA. Accessed 3 Oct. 2024.