Files
Publication Date
5-2026
Disclaimer
These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly, these guidelines should guide care with the understanding that departures from them may be required at times.
Objective of the Guideline
To provide care standards for the otherwise healthy patient diagnosed with croup in the Emergency Departments (ED), Urgent Care Centers (UCC), outpatient settings, and inpatient medical units. Standardization of care may reduce overutilization of chest radiographs, viral testing, and other laboratory testing. It may also decrease unnecessary hospitalization and inpatient length of stay.
Target Users
Physicians (Emergency Medicine, Urgent Care, Hospital Medicine, Primary Care, as well as fellows and residents in those settings); Advanced Practice Nurses; Physician Assistants; Staff Nurses; Respiratory Therapists
Clinical Questions Answered by Guideline
1. Is a lower dose of dexamethasone (0.15mg/kg) as effective as the standard dose (0.6 mg/kg) in improving clinical outcomes in children with croup (inpatient or outpatient)?
2. In patients aged 6 months to 6 years with croup (laryngotracheitis) seen in an acute care setting, which patient characteristics are associated with treatment after hospital admission?
3. Does observation time after a single dose of racemic epinephrine (RE) administration of 2 hours versus 3 or more hours result in similar treatment failure in children with croup?
Keywords
Croup; Prednisolone; Dexamethasone
Disciplines
Pediatrics
Recommended Citation
Children's Mercy Kansas City, "Croup" (2026). Clinical Pathways.
https://scholarlyexchange.childrensmercy.org/clinical_guidelines/13
Comments
Clinical Pathways are updated on a revision schedule. Primary files will always be the most current update. Previous revisions are available upon request from Children’s Mercy Library Services.
Finalized 2/2016, Algorithm revised: 11/2022; 5/2026
Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members.