Croup - When is it serious??

[wheresmypaddle]

I have read a few postings mentioning the need to take poor DC's to A&E due to croup. I apologise if this seems a silly question but does anyone know at what point croup becomes serious enough to need medical intervention.

I ask because DS (2.9yo) has croup which is getting worse each night. I have been giving him neurofen, radiator is off and window slightly open. I have also tried the steamy bathroom thing, not sure if it works or just distracts him and helps him to become calmer.

Last night he was really struggling and became panicky a couple of times. He was pointing into his mouth- he seemed convinced he had swallowed something (we did check and I feel sure he hadn't).

Anyway, now I am wondering if I need to take it a bit more seriously and take him to docs / hospital if it happens again. Can anyone suggest at what point I do this rather than just assuming it will be OK with cuddles and steam??

I was told by GP that it's time to seek help if he's drooling and if there's any blueness about the lips.

DS3 gets awful croup. If the steam hasn't helped after 20 mins I take him outside into the cold air, wrapped up warmly of course. Again, this was recommended by GP and seems to work.

I do wonder what the neighbours think about the sealion on my doorstep at 3 in ther morning, though!

I boil the kettle in the downstairs loo and sit in there, btw. It's a small room and gets very steamy quickly.

I am not sure taking them to the gp would be any use.

I think croup is an acute thing - the airway narrows temporarily as a result of the virus, and when they are asleep it dries out and closes up a bit more making them have the characteristic cough. Managing it is the key normally I think.

Trying to keep them a bit more upright, and the air more damp, and having a decongestant around in the room (eg karvol on a tissue) all help to keep the airway open enough.

If they do get very coughy then cold air, or steamy room and sitting up right and keeping calm help. If that isn't helping, or their lips start to go blue, or their chests pull in with breathing then it is time to call the ambulance because they need a quick response (eg a nebuliser) to open the airway- and maybe a trip to hospital and a dose of steroids.

Usually they seem to be croupy for 2-3 nights and then they fight off the virus and are fine until the next time.

And they generally grow out of it by about 5 - maybe their airways are just that bit bigger by then.

To be honest when Dcs had it I only called the doctor once when DS's lips went blue and by the time the doctor got there he was better anyway.

By the way - we ended up with the ambulance to A&E at midnight the first time (age about 3) when we really didn't know what it was or how to deal with it.

After that once we understood it better we were able to fend it off with the things mentioned previously.

When DD's lips turn blue lips and she is really struggling for breath (with her chest 'pulling in', as throckenholt describes) off we trot to A&E. But she gets it very severely and it worsens very quickly.

It sounds as if cuddling and steam is working for you, so follow your instincts unless DS gets much worse suddenly.

Thanks everyone. I will try the Karvol on a tissue (didn't realise the stuff actually worked), and maybe take him outside rather than the bathroom.

Its hard to convince DS that its OK and to stay calm, when I am only pretending to be calm myself- but you have reassured me a bit so thanks.

you staying calm is a big thing - it really helps them calm down too.

And karvol seems to work with mine - so much so that I now use it myself when I have a cold. I didn't find obas oil (which I think is similar) had any real affect.

I guess it is a combination of things that act together to help keep the airway open enough. Damp cloth near the bed, and a bowl of water nearby, plus not laying flat, and the karvol were often enough to stop a bit of a cough going to a full blown attack. When it didn't 20 mins sitting in a very steamy room helps. And sometimes giving them cough medicine or a drink once they calmed down a bit help (again probably just helped to soothe the airway).

Understanding it and knowing when it is getting too bad really helps too.

I wouldn't wait until their lips turn blue. I took DD2 to the GP in November and he told me to go straight to A&E as she was breathing noisily (stridor at rest) and took more than 60 breaths a minute, which apparently is a sign that they struggle to get enough oxygen. She got steroids and stayed in overnight. But maybe you're braver than I am

I should add she was only 7 months then... I was less worried about DD1, who had had it the week before and is 2 1/2.

I was told when skin pulling in between ribs or around neck on breathing - that's when I took dd - they whipped her straight in and dosed her up with steriods to bring down the inflamation, had an overnight stay, much better after that.

i'd say that by the time your dc is drooling and blue around the lips it's way past the time they should have got checked out! Croup is one of those things that gets worse at night (as you've noticed) and can vary in severity from child to child, or from one episode to another. Yes it can resolve on its own, or the steamy bathroom or the out in the cold thing can be really good, but I'd say if the child is flaring his/her nostrils, or sucking in around ribs or on the neck (as described by 10pounds above, or if their breathing rate is high, then you should get checked. Also if the child is indicating that they can't breathe or swallow properly I'd go too. A dose of steroid usually helps a lot. I've seen children come in to hospital with croup who've been really very poorly. If they've been stuggling for a few days, even if it's not too severe, they can get quite exhausted from it.

Just chacked into 'threads you are on' and saw the later replies- thanks everyone for your help.

DS's croup peaked on Thursday night but is now getting better every night. I think the Karvol helped and I have completely turned off the radiator in his room and left the window open too- seemed to do the trick.

Thanks everyone.

Hi I suggest putting Vicks vapour on his feet and put socks on going to bed as it stains sheets. It works for 3 yr old DS. Also put an unpeeled onion in a bowl in his room which will absorb bacteria. My 3yr old had a cough from sept to christmas when the GP prescribed some homeopathic remedy and within 24 hrs I saw a great improvement. I suggest you visit a homeapath. Good Luck.