You are a consultant in an urban district ED when a 20-month-old girl presents with stridor and cough. She has had croup previously and has required transfer to a tertiary paediatric hospital.

1. Other than croup, list (4) differentials for stridor in the paediatric population. 4 marks

You suspect she most likely has another episode of croup.

2. List (4) signs of severe croup. 4 marks

You diagnose the child with severe croup. She is currently being managed in a resus bay, she is agitated and crying inconsolably

3. Outline your (4) immediate treatment priorities. 4 marks

The child starts to appear exhausted and has decreased LOC with O2 sats of 90% despite low flow NPO2 therapy and your earlier interventions

4. State (6) important steps in preparing for intubating this child in the ED, including drugs for intubation. The child weighs 12 kg. 6 marks