Questionnaire/history: Sudden-onset, seal-like barking cough? Hoarse voice? Abnormal, high-pitched, musical breathing sound (stridor)? Persistent agitation? Impending respiratory failure? - Sternal/intercostal recession? - Belly sinking in? - Lethargy/fatigue? - Pallor or cyanosis? - Decreased level of consciousness? Fever? Prodromal upper respiratory tract symptoms (coryza, non-barking cough, mild fever) present for btw 12-48 h? Past medical history? Current medication? Drug allergies? Examination: Pallor or cyanosis? Lethargy/fatigue/decreased level of consciousness? Nasal flaring? Sternal/intercostal recession? Asynchronous chest wall and abdominal movements? RR? - > 60 breath/minutes? Temperature? Management: If hospital admission not required (mild illness) oral dexamethasone (0.15 mg/kg) as solution or soluble tablets to be taken immediately Advised: - To give paracetamol or ibuprofen (if no vomiting) prn - To encourage to take fluids regularly - To check on child regularly, including through the night - About the expected course of croup, including that symptoms usually resolve within 48 hours - To take child to hospital if continuous stridor, the skin between the ribs is pulling in with every breath and/or the child is restless/agitated - To call an ambulance if child is very pale, blue or grey (included blue lips) for more than a few seconds, unusually sleepy or not responding, having a lot of trouble breathing (eg belly is sinking in while breathing, nostrils may also be flaring in and out), upset (agitated or restless) while struggling to breath and cannot be calmed down quickly, want to sit instead of lie down, cannot talk, drooling, having trouble swallowing - To read Patient UK info 'Croup' and NHS info 'Croup' Reference(s): NICE CKS: Croup Information for patients/carers: NHS Health A to Z: Croup Patient UK: Croup