Discharge

Most children with mild croup can be discharged home following a single dose of dexamethasone.

Those with moderate croup need to be observed for a minimum of four hours following a dose of dexamethasone and then re-assessed.

Those with severe croup must be admitted. In children discharged home, advice must be given to a parent and documented in the notes:

Discharge advice to parents and carers

Croup is a viral illness that is characterised by a barking cough and noisy breathing. Croup can re-occur. This illness typically lasts 3-4 days.

Your child has been given a dose of steroids. In mild cases one dose is normally enough. In moderate cases a second dose may be given 12 hours after the first dose.

In mild croup, your child has a barking cough but does not usually have noisy breathing at rest or is not having problems breathing. Mild croup can usually be managed at home with the following:

• Try and calm your child, as breathing is more difficult when your child is upset
• If your child has a fever and is miserable give paracetamol (Calpol)
• Croup can be worse at night; your child may be more settled if someone stays with them

You should return to the Emergency Department immediately if:

• Your child’s breastbone sucks in when breathing in
• If your child is struggling to breath
• If you child has noisy breathing
• If your child is drinking less than 50% of normal or is having dry nappies
• You are worried for any reason

Further information: Croup – Healthier Together