Episode 16 (Short): Prehospital Croup Management 

Brought to you by The National Association of EMS Physicians (NAEMSP) and Missouri Emergency Medical Services for Children (MO-EMSC).

Hosts: Dr. Joelle Donofrio-Odmann and Dr. Joseph Finney

Website: https://sites.libsyn.com/414020 

Episode Summary

In this SHORT episode, we discuss one of the most common pediatric respiratory emergencies, croup, and what EMS providers need to know during peak viral season. Drawing from real-life experience and current field trends, we review how to recognize upper airway obstruction, differentiate it from lower airway conditions, and manage severe cases prehospitally.

Listeners learn why children's smaller airways make them especially vulnerable to swelling, how to tell croup from foreign body aspiration, and when to escalate care. Join us as we walk through the stepwise management of croup, including:

• Recognizing stridor and assessing severity

• Using nebulized (racemic) epinephrine and dexamethasone effectively

• Knowing when IM epinephrine may be lifesaving

• Avoiding unnecessary albuterol in upper airway disease

• Calming and positioning strategies to minimize distress

We also highlights the Westley Croup Score, a simple clinical tool to grade croup severity based on stridor, retractions, air entry, cyanosis, and level of consciousness — helping EMS providers communicate clearly with receiving teams and guide treatment intensity.

We emphasize timely hospital notification, monitoring for recurrence as nebulized epinephrine wears off, and when to consider admission.

For more examples of respiratory distress and croup symptoms in children, visit:
🔗 KidsHealth NZ – Signs That Children Are Struggling to Breathe