Notes – Pediatric Respiratory Distress (Croup)

Pediatric Respiratory Distress (Croup)

Patient Safety Considerations

  1. Routine use of lights and sirens is not recommended during transport
  2. Patients who receive inhaled epinephrine should be transported to definitive care

Notes/Educational Pearls

Key Considerations

  1. Upper airway obstruction can have inspiratory, expiratory, or biphasic stridor
  2. Foreign bodies can mimic croup, it is important to ask about a possible choking event
  3. Impending respiratory failure is indicated by:
    1. Change in mental status such as fatigue and listlessness
    2. Pallor
    3. Dusky appearance
    4. Decreased retractions
    5. Decreased breath sounds with decreasing stridor
  4. Without stridor at rest or other evidence of respiratory distress, inhaled medications may not be necessary

Pertinent Assessment Findings

  1. Respiratory distress (retractions, wheezing, stridor)
  2. Decreased oxygen saturation
  3. Skin color
  4. Neurologic status assessment
  5. Reduction in work of breathing after treatment
  6. Improved oxygenation after breathing

Quality Improvement

Associated NEMSIS Protocol(s) (eProtocol.01)

  • 9914223 – Medical-Respiratory Distress-Croup
    • Protocol Age Category: 3602005 – Pediatric Only

Key Documentation Elements

  • Document key aspects of the exam to assess for a change after each intervention:
    • Respiratory rate
    • Oxygen saturation
    • Use of accessory muscles or tracheal tugging
    • Breath sounds
    • Air entry
    • Mental status
    • Color

Performance Measures

  • Time to administration of specified interventions in the protocol
  • Frequency of administration of specified interventions in the protocol

 References

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