Monitoring

The respiratory rate, work of breathing, oxygen saturation and pulse rate should be carefully monitored. The work of breathing, respiratory rate, volume of stridor and pulse rate should decrease if the treatment is working.

How can work of breathing be assessed and quantified?

Measuring the work of breathing requires complex instrumentation, measuring it in patients with acute serious illness is difficult and risky. Instead, physicians determine if the work of breathing is increased by examining the patient looking for signs of increased breathing effort. These signs include nasal flaring, the contraction of sternomastoid, and thoraco-abdominal paradox (see-saw breathing).

Children with mild croup should be observed for a minimum of 2 hours and those with moderate croup should be observed for a minimum of 4 hours following administration of Dexamethasone.