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First Aid - Croup with Stridor
Stridor: A Complication of Croup
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First Aid Advice For Stridor (Harsh sound with breathing in) or Constant Coughing:
|When to Call Your Doctor|
|Call 911 Now (your child may need an ambulance) If|
|Call Your Doctor Now (night or day) If|
|Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If|
|Call Your Doctor During Weekday Office Hours If|
|Parent Care at Home If|
|HOME CARE ADVICE FOR CROUPY COUGH|
- Most children with croup just have a barky cough.
- Some develop tight breathing (called stridor).
- Remember that coughing up mucus is very important for protecting the lungs from pneumonia.
- We want to encourage a productive cough, not turn it off.
- Humidifier: If the air is dry, run a humidifier in the bedroom. (Reason: Dry air makes croup worse.)
- Homemade Cough Medicine:
- Goal: reduce the irritation or tickle in the throat that triggers a dry cough.
- AGE: 3 months to 1 year: Give warm clear fluids (e.g., water or apple juice) to treat the cough. Amount: 1-3 teaspoons (5-15 ml) four times per day when coughing. Avoid honey until 1 year old.
- AGE 1 year and older: Use HONEY ½ to 1 teaspoon (2-5 ml) as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. (If not available, can use corn syrup.)
- AGE 6 years and older: Use COUGH DROPS to coat the irritated throat. (If not available, can use hard candy.)
- Non-Prescription Cough Medicine (DM):
- Non-prescription cough medicines are not recommended. (Reason: no proven benefit for children). Never use them under 4 years of age. (Reason: risk of serious side effects and not approved by FDA)
- Honey has been shown to work better for coughs.
- If you decide to use a cough medicine from your drugstore and your child is over age 4 years, choose one with dextromethorphan (DM). It's present in most non-prescription cough syrups.
- Indication: Give only for severe coughs that interfere with sleep, school or work.
- DM Dosage: See Dosage table. Give every 6 to 8 hours for severe coughs that interfere with sleep, school or work.
- Coughing Spasms:
- Expose to warm mist (e.g., foggy bathroom).
- Give warm fluids to drink (e.g., warm water or apple juice) if over 3 months of age.
- Amount: If 3 months to 1 year of age, give warm fluids in a dosage of 1-3 teaspoons (5-15 ml) four times per day when coughing. If over 1 year of age, use unlimited amounts as needed.
- Reason: both relax the airway and loosen up the phlegm
- Fluids: Encourage your child to drink adequate fluids to prevent dehydration. This will also thin out the nasal secretions and loosen the phlegm in the airway.
- Fever Medicine: For fever above 102° F (39° C), give acetaminophen (e.g., Tylenol) or ibuprofen.
- Observation During Sleep: Sleep in the same room with your child for a few nights. (Reason: can suddenly develop stridor at night)
- Avoid Tobacco Smoke: Active or passive smoking makes coughs much worse.
- Contagiousness: Your child can return to child care or school after the fever is gone and your child feels well enough to participate in normal activities. For practical purposes, the spread of croup and colds cannot be prevented.
- Expected Course: Croup usually lasts 5 to 6 days and becomes worse at night.
- Call Your Doctor If:
- Stridor (harsh raspy sound) occurs
- Croupy cough lasts over 14 days
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.