Pediatric Respiratory Emergencies

Croup (laryngotracheobronchitis) is a viral infection causing upper airway swelling, classically presenting with a distinctive barky, seal-like cough, hoarseness, and inspiratory stridor that often worsens at night — most cases are managed with cool mist or humidified air and, for more significant cases, corticosteroids and/or nebulized epinephrine, with close monitoring of work of breathing. Epiglottitis is a rarer but far more dangerous cause of stridor — a bacterial infection causing severe swelling of the epiglottis, presenting with sudden high fever, drooling, a muffled "hot potato" voice, and a strong preference for sitting upright and leaning forward (the tripod position) — and it is a true emergency: the airway can obstruct completely and suddenly, so the nurse must never attempt to examine the throat with a tongue depressor or lay the child flat, since either action can trigger complete airway obstruction; the priority is keeping the child calm, upright, and undisturbed while urgently arranging airway management by the most experienced available provider.