Symptoms and first aid for false croup in a child

What is false croup? In medical terminology it is called acute obstructive laryngotracheitis. This term refers to a syndrome of upper respiratory tract involvement (larynx and trachea) in the vast majority of cases caused by viral infections. The larynx is our vocal apparatus, quite complex, in fact, and the trachea is, so to speak, a tube that connects the larynx with the bronchi and lungs.

Probably, if there is false croup, there must also be a true one? True croup is a severe condition that occurs as a result of laryngeal diphtheria. In this case, the formed pseudomembranes block the airway lumen, which requires urgent hospital treatment and administration of anti-diphtheria serum. Fortunately, due to routine vaccination against diphtheria, such a condition is now almost never seen.

False croup, which occurs in children, mostly under the age of 6, due to anatomical features of the larynx (in children it resembles a funnel, while in adults it is cylindrical), as well as differences in mucosal response to swelling (in children it reacts more quickly), is quite commonly encountered in clinical practice.

How does it present? Anyone who has ever experienced this condition is unlikely to forget it or confuse it with anything else. It usually occurs at night: the child wakes up unable to inhale, their voice becomes hoarse, and when they try to cough to relieve the condition, the cough sounds like a barking dog. During inhalation, relatives hear a characteristic wheezing sound.

Along with these symptoms, there may also be runny nose, fever, headache, muscle pain, but croup can often be the very first symptom of an acute viral infection.

Croup requires medical attention because the child’s condition can change rapidly. According to modern standards, the drug of choice is adrenaline (epinephrine) via inhalation; in other cases, steroid hormones are used via inhalation or injections. In some countries, these drugs are also available in syrup form. However, this can only be done under a doctor’s supervision. Therefore, the first thing caregivers should do is call emergency services.

What can relatives do before doctors arrive?

First aid for false croup

• hold the child in your arms or keep them in a raised position in bed — the upper body should be upright (gravity will already help reduce swelling);
• if possible, calm the patient — unnecessary stress and anxiety will only worsen the attack;
• open windows or vents — the room should be cool; if possible, use a humidifier or air ionizer; if unavailable, the child can be taken into the bathroom and cold water turned on so the air becomes humidified with steam;
• give warm fluids without restriction — water, unsweetened tea, compote, fruit drinks;
• if the temperature rises, give ibuprofen or paracetamol.

What is not recommended?

• breathing over hot steam (although this used to be recommended in the past)
• independently giving the child antitussive or antiallergic medications (they may cause drowsiness, making breathing more difficult).

Prevention of false croup

• the room where the patient is should be cool;
• the air should be humid and fresh;
• the patient should be given plenty to drink;
• avoid smoking in the room where the child is present.