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Croup

  • Labs

    • lateral neck xray (subglottic narrowing)
    • gram stain and culture (guide abx for bacterial tracheitis)
  • Tx for viral croup

    • dexamethasone 0.15-0.6 mg/kg (10 mg max) PO or IM
    • if severe: Nebulized racemic epinephrine 0.05 mL/kg up to 0.5 mL of a 2.25% solution
    • d/c if:
      • O2 sat > 90 on RA
      • at least 3 hours since last dose of epi
      • nontoxic, no dehydration
  • Tx for bacterial tracheitis

    • manage airway, intubate is needed
    • ampicillin/sulbactam 50 mg/kg or ceftriaxone 50 mg/kg IV
    • clindamycin 10 mg/kg
    • add vancomycin 10 mg/kg IV q6h if MRSA
  • Pathogen

    • paraflu or bacterial

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