Tuesday, September 27, 2011

Hello Fall aka Hello Croup Season

Elsewhere in the country the landscape is awash with brown, orange and red leaves as Summer begins to give way to Fall. Not so much in Tucson. Still the change in seasons are evident, the temperatures are less blistering for a start and in this Tucson family's home the first day of Fall was marked by a loud barking cough. Croup. 

Four-thirty in the morning we woke to the characteristic barking cough of croup. Our child had not seemed sick the night before, maybe a little sniffle, but now between the coughing there was sobbing. The immediate reaction was to go outside and see if the cool night air would ease the cough, but of course this is Tucson in September and the air was not that cool or humid. We ran the shower steaming up the bathroom and hung out in there, cradling our not so small child and waiting for the cough to subside. By about fifteen minutes the cough had begun to subside, by thirty minutes it was gone. She went back to sleep and we kept a close eye on her to make sure that her breathing remained stable and kept her home from preschool. The next night we had the same experience, but earlier in the morning. By the third night we were in the clear. No coughing. No croup. 

The most common cause of croup is the same viruses, human parainfluenza viruses, that cause the common cold. The characteristic barking croup cough is caused by swelling around the vocal chords (laryngotracheobronchitis) and other parts of the upper and middle airway. In young children, under the age of five, their voice box, windpipes and tubes leading to the lungs are not mature and so swelling around them can make it difficult for a child to breath and why potentially croup can be very dangerous if not treated appropriately. As children get older their lungs and windpipes mature, widen and they are less likely to get croup. However, most of the time the croup is not serious and can be dealt with at home. 

From our TMC Health Encyclopedia which you can access any time night or day, here are some suggestions for dealing with croup:
  • Try to stay calm during an attack, and soothe your child. Crying can make the swelling in the windpipe worse and make it even harder to breathe.
  • Breathing in moist air seems to help during a croup attack. Fill your bathroom with steam from the hot water faucets, and sit in the room with your child for 10 minutes. 
  • Breathing cool night air also seems to help sometimes. Dress your child in warm clothes, and go outside for 10 minutes. 
  • If symptoms improve with these methods, put your child back in bed with the humidifier blowing nearby. 
  • Do not smoke, especially in the house. 
  • If the symptoms happen during the middle of the night, it is a good idea to sleep in or near your child's room until morning. 
  • Be sure to keep your child well hydrated. Offer water, flavored ice treats (such as Popsicles), or crushed ice drinks several times each hour.
If your child has severe croup or has not responded to home treatment, medicines may be used to decrease airway swelling. These are usually given in a doctor's office or an emergency room. In rare cases, a child needs to stay in the hospital for treatment. If your child’s symptoms don't get better after 30 minutes, call or see your doctor. If the attack is in the middle of the night and you are very worried, consider taking your child to the emergency room. 
If your child has severe difficulty breathingcall 911 or other emergency services immediately.

  • Breathes very fast or grunts with each breath. 
  • Appears anxious or exhausted during feeding or is unable to nurse or take a bottle. 
  • Uses the neck, chest, and abdominal muscles to breathe, causing a "sucking in" between or under the ribs (retractions).
  • May flare the nostrils when breathing in. 
  • May need to sit up and lean forward or tilt the nose up as if sniffing the air. 
  • May fight any attempt to change his or her position. 
  • Has pale, gray, or bluish skin (especially the tongue, lips, earlobes, and nail beds), or the skin is mottled (patchy pale and blue pattern).

Call 911 or emergency services if these signs are present.

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