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Emergency Department Discharge Instructions

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Croup

Category

Children

Emergency Care Discharge Instructions

Instruction summary

Croup is characterized by a barky cough and a fever. It usually lasts five to seven days. The cough is typically worst on day two and is worse in the nighttime.

In the ER, your child may have been given a prescription for a single dose of a steroid medication, such as Dexamethasone or Prednisolone. This medication will help the croup to go away faster.

It is important to keep your child hydrated. You can use formula or breast milk if they are less than one year of age, or Pedialyte, flat ginger-ale, or water if they are over one year of age.

If your child has a fever, you can help him or her feel better by treating the fever with acetaminophen (which is the same thing as Tylenol) or ibuprofen (same thing as Advil or Motrin). If your child does not appear to be getting better an hour after giving one of these medications, you can try the other medication.

For example, if your child is not better one hour after taking ibuprofen, you can give your child acetaminophen. While it is very safe to try both, it is important to make sure that you give your child the right dose of each, according to their weight, as instructed on each box. Avoid using any over-the-counter cold medications at the same time: these medications often have several medicines in them, including acetaminophen or ibuprofen, so you could end up giving too much of one or the other if you add cold medications.

There are also some simple home treatments that you can try
  1. Using steam or cool mist to help your child to breathe easier
  2. Putting a humidifier in your child’s room
  3. Opening up the window in your child’s room to allow in the cool night air (often croup improves on the way to the ER, because the child was exposed to the cool night air on the way there)
Reasons to return to the ER
  1. Dehydration. Signs of dehydration:
    • Producing fewer wet diapers or peeing less
    • A dry mouth with no visible spit bubbles
    • No tears made when crying
  1. Lethargy. Lethargy is an extreme form of tiredness when a child is only minimally responsive. An example of a lethargic child is a child who is lying still and does not make eye contact with you when you speak to them.

  2. If your child is making a high pitched breathing sound even at rest