Clinical pathways and guidelines
Croup(external link) Auckland Regional HealthPathways, NZ, 2020
Croup(external link) Starship Clinical Guidelines, NZ, 2020
Listen to the concerns of parents
The following tips from BPAC are also useful.
Cough in children, regardless of the underlying reason, can cause significant distress, disruption of daily activities and a lack of sleep for both the child and the parents. Ask open questions following the standard FIFE format, such as:
- Feelings: What are your concerns?
- Ideas: What do you think is the cause of the cough?
- Function: How is the cough affecting your child and yourself?
- Expectations: What do you think is needed to help resolve the cough?
Responses to these questions should help uncover parental concerns, suggest areas requiring further direct questioning and guide the type and range of advice given. In many cases the answers may also reveal the likely diagnosis.
See more: Cough in children(external link) BPAC, NZ, 2010
Use of steam – why is it no longer recommended?
A meta-analysis in 2006 concluded, "We have been unable to find evidence that the croup score of children managed in an emergency setting with mild to moderate croup improves substantially with inhalation of humidified air. There is no evidence to guide treatment in primary care. In the ED, however, there is clear benefit from the administration of nebulized or oral steroids and there is no justifiable reason to continue to offer standard humidification as a mainstay of treatment".
Moore M, Little P. Humidified air inhalation for treating croup: a systematic review and meta-analysis(external link) Family Practice. 2007;24(4):295-301.