Safety and efficacy of nebulized racemic epinephrine in conjunction with oral dexamethasone and mist in the outpatient treatment of croup.
OBJECTIVE
To identify patients with croup who after treatment with nebulized racemic epinephrine, oral dexamethasone, and mist may be safely discharged home after a period of observation.


METHODS
Prospective interventional.


METHODS
Urban children's hospital emergency department.


METHODS
Children with croup who received racemic epinephrine for the treatment of stridor at rest.


METHODS
After treatment with .5 mL racemic epinephrine, .6 mg/kg dexamethasone PO, and mist, patients who were assessed as being safe for discharge after 3 hours of observation were discharged home and contacted for 48-hour follow-up.


RESULTS
Fifty-five patients with croup were treated with racemic epinephrine. Thirty patients (55%) had sustained responses and were discharged home after 3 hours of observation. No recurrence of respiratory distress and no return visits for medical care were reported (95% confidence interval, 0% to 8.0%).


CONCLUSIONS
Patients with croup who are treated with racemic epinephrine, oral dexamethasone, and mist may be safely discharged home if the patient is assessed as ready for discharge after 3 hours of observation.
Ledwith
C A
CA
Section of General and Emergency Pediatrics, Children's Hospital, Denver, CO.
Shea
L M
LM
Mauro
R D
RD
D000280:Administration, Inhalation; D000284:Administration, Oral; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D003131:Combined Modality Therapy; D003440:Croup / Q000188:drug therapy*; D003907:Dexamethasone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D008297:Male; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D064705:Racepinephrine; D012008:Recurrence; D014867:Water
D014867:Water; D003907:Dexamethasone; D064705:Racepinephrine; D004837:Epinephrine