I have had the same experience on night visits to very croupy kids in past. I
was never sure whether it was the vast quantity of steaming (which gave parents
sth to do) or the fact that by then the child had been out of bed for the best
part of an hour. It also worked for my own but nowhere near as well as a budesonide
via nebuliser. That was an example of a proven therapy that took a good while
to get in local hosp practice despite widespread dissemination/critique via
the Drugs and Therapeutics Bulletin in the UK some time ago.
Kyran Farrell
>I did have one fascinating pt (to me, but I'm easily amused) not long
>ago...7ish yr old boy brought in by father and I was told that he had
>sporadic episodes of recurrent 'croup' over the past 5 yrs and that all he
>needed was a saline mist (via nebulizer) and he'd be fine.
>My first reaction was to question the dx, although the child was breathing
>noisily, but indeed on exam, the child had significant inspiratory rattles
>and noises and his cough was doggier than snoop doggy. So, I shrugged my
>shoulders and went along with the scheme (though I too was convinced that
>'mist is not ebm' but I decided to humor dad). The child's response was the
>most dramatic thing I've ever seen. Within minutes his breathing went from
>stridorous to quiet (while moving good volume) and he stopped laboring.
>Yes, of course this is the anecdote that proves nothing. But what do
>listers make of this? Dad said about twice yearly the child would do this
>and his reaction was always identical.
>jeanne
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