Croup vs. Epiglottitis

Hi again, everyone. Now I'm going to talk about two serious pediatric emergencies, croup and epiglottitis. These conditions might look similar at first, but they have some key differences that we need to be aware of. Croup usually affects kids under the age of three and is caused by a viral infection that leads to swelling in the upper airway. On the other hand, epiglottitis is much more common in kids age 3 to 6 and is typically caused by a bacterial infection, which can cause severe epiglottic swelling and even lead to respiratory arrest. Now, here's an important pearl to remember. Epiglottitis is very painful. That means that any movement of the epiglottis hurts. So the patient will do anything they can to stay still, and they'll even try to avoid coughing. So if you see a child with a persistent cough who doesn't appear to be experiencing pain with that cough, it's probably not epiglottitis. Now, when treating these patients, we're going to use nebulized epinephrine. This works great for both croup and epiglottitis. Why? Because of its Alpha 1 vasoconstrictive effects. Be sure to avoid albuterol, as it doesn't have the same effects and actually may make things worse. So when you're treating a child with suspected croup or epiglottitis, simple. Give them 3 milligrams of EPI 1 to 1000, which is a 1 milligram per milliliter through a nebulizer. No dilution necessary. Remember, don't stress the patient out or try to intubate them if they need it. You can provide BVM ventilation and get them to the nearest comprehensive pediatric emergency department, the cped, as quickly as possible. Keep these tips and pearls in mind and you'll be well equipped to handle these critical pediatric emergencies. Thank you.