Peds

Croup / upper airway obstruction

Before / During / After / Pitfalls

Before

• Keep child calm; nebulized epinephrine/steroids and ENT/anesthesia/peds support early.
• Intubation should be controlled with smaller tubes and expert help when possible.
• Avoid agitating a tenuous upper airway.

During

• Smaller ETT than age formula may be needed.
• Gentle technique; avoid repeated traumatic attempts.
• Surgical airway in small children is complex; get expert help early.

After

• Monitor edema, leak, and tube security.
• Continue croup therapy and ICU planning.
• Extubation planning requires airway expertise.

Pitfalls

• Agitating the child unnecessarily.
• Tube too large.
• No smaller backup tube.