Nondrug management of croup

Nondrug management of croup should include the following:

• minimising handling to avoid worsening of symptoms
• keeping the child with parents or carers to reduce distress—many children will become more settled if someone stays with them (especially during the night when croup becomes worse)
• keeping the child calm (eg sitting quietly, reading or watching TV)
• allowing the child to adopt a position of comfort that minimises airway obstruction
• reassuring and educating parents or carers on the cause, usual course and management of croup to relieve anxiety
• providing a carer information sheet; a fact sheet is available from The Royal Children’s Hospital (Melbourne) website.

Inhalation of humidified air or steam is not recommended because there is no evidence of benefit and it can cause harm (eg scalds).