270 CROUP IN A PEDIATRIC EMERGENCY DEPARTMENT(ED)

The aim of this study was to assess clinical patterns and management of croup in a well defined area, served by only one children's hospital during one year. 91 patients(pts)presented croup(0.5% of total ED consultation, 4.7% of ac.resp.tract disease):80 were diagnosed as ac. laryngotracheobronchitis(LTB), 11 as spasmodic croup(SC). LTB pts(61% male) were aged from 1 month to 15.5 yrs(M 3 yrs); 45% presented in autumn, 41% during the night. Symptomatology consisted of cough(73%), dyspnea (29%), fever(21%)and dysfonia(20%). Most common treatments were nebulized sterile saline(nss)alone(53%)or combined with beclomethasone(bt, 9%), phenylephrine(pe, 3%), bt+pe or oral corticosteroids(cs,13% each one) 15 pts were hospitalized:management consisted of aerosol with pe(69%) or with bt(31%), plus nss or oral cs(23% each one). Hospitalization last ed less than 2 days. SC pts(64% female)were aged from 8 months to 7 yrs (M 2.8 yrs). 55% presented in winter, 72% during the night. Most common symptoms were cough(96%)and dyspnea(46%). Management consisted of nss alone(55%)or in combination with bt(9%), pe(9%), bt+pe(27%). One patient was hospitalized for a night and treated with nss+bt. In our area croup is usually managed at home. Patients referring to the ED are newly diagnosed or have not responded to home treatment.