False croup in children is a dangerous condition that requires correct parenting. Croup can develop in any child, and therefore the famous pediatrician and TV presenter Yevgeny Komarovsky strongly recommends that all parents study the signs and rules for helping babies with false croup.
About the disease
Speaking of croup, many people recall the dangerous diphtheria croup, which claimed many children's lives before the diphtheria vaccination was put on a grand scale. Such a croup is called true. And it is the reason that distinguishes it from the false, which leads to the narrowing of the larynx.
In diphtheria, the larynx narrows due to the accumulation of diphtheria films. False croup can develop against the background of a wide variety of typical childhood and not only viral diseases, which are accompanied by respiratory symptoms.
Croup is a complication of ARVI, influenza, which develops due to swelling of the tissues of the larynx due to inflammation. The larynx in children and in a normal state is always much narrower than in an adult, but during the croup it narrows even more, and in a certain place - in the area of the vocal cords.
There is no vaccination against such a complication; it is almost impossible to predict in which of the children a common seasonal viral infection will cause croup, and in which everything will be limited to only a runny nose and cough. In the absence of timely and correct assistance, the child may suffocate.
The most common cases of false croup are recorded in childhood: from birth to three years. The risks decrease by the age of 6-7, and after 9-10 years, the likelihood of developing croup is generally minimal, because the trachea, vocal cords and larynx grow with the child, which reduces the likelihood of stenosis.
Causes
If we talk about what diseases most often develop the condition of croup, then in the first place it is worth putting infections caused by the parainfluenza virus. It is followed by influenza viruses of strains A and B, adenoviruses.
In the vast majority of cases, this is not an independent disease, but a complication.
The weaker the baby's immunity, the more often the baby gets sick, the higher the likelihood that the next viral infection will be complicated by a false croup. More susceptible to the disease are children born before the due date (premature), children suffering from rickets and having any other congenital or acquired chronic diseases.
At first, the body of any child tries to somehow compensate for the inconveniences (in this case, stenosis), and in a compensated form, the disease is not too dangerous. But the croup tends to intensify, and therefore, simultaneously with the growth of puffiness, the decompensated stage begins, when the child's body begins to suffer from oxygen deficiency. Death can occur from asphyxia or heart failure.
Classification
About what specific pathogen led to inflammation and swelling of the larynx, experts speak of as secondary information. It is much more important to distinguish the type according to the symptomatic picture, depending on the degree and severity of the symptoms.
It is this information that will answer the question of what and how to do, go to the hospital or receive treatment at home.
- Initial croup - always compensated, the child begins to suffer from shortness of breath only after he actively moves, experiences certain loads. Breathing in is more difficult than breathing out.
- Croup of the second degree called moderate. With it, the compensatory abilities of the body are reduced, shortness of breath is noticeable not only after physical exertion, but also in a calm state.
- False croup of the third degree - heavy. Take it, there are already signs of a systemic oxygen deficiency: the child's lips turn blue, shortness of breath is strong and constant, the skin becomes poor, the baby's breath is hard.
- Complications of the fourth degree - the most dangerous and difficult, with it, hypoxia becomes systemic, capable of becoming lethal at any time. Organs and systems experience oxygen deprivation, especially the nervous system and the brain, which may lead to certain consequences of a neurological nature, even if the child survives.
Signs and symptoms
Dr. Komarovsky urges parents to focus on the triad of symptoms that always accompanies the state of false croup: a difficult breath, a barking cough and a hoarse voice.
If all three signs are present, the baby is more likely to have croup.
If a child gets sick with a viral infection, this does not mean at all that this dangerous threatening condition will appear. Most often, the first symptoms of laryngeal edema begin to make themselves felt on the second or third day after the onset of a viral infection. The first is usually a dry cough that gets worse at night. Then the hoarseness of the voice appears. If the baby begins to cry, the barking cough will become stronger - and this is an important diagnostic sign.
Breathing in and out becomes noisy. At first, the changes are hardly distinguishable, but then, depending on how narrow the larynx has become, the whistle during breathing will become more noticeable.
If the false croup goes to the extreme fourth degree, two of the diagnostic signs disappear - cough and wheezing when breathing. But the pressure decreases, convulsive syndrome may develop. In the absence of help, a hypoxic coma begins.
If the child feels bad in the evening, Komarovsky emphasizes, then at night it will certainly get even worse, since it is at nighttime that the most severe croup attacks occur. Parents should be prepared to help.
How can you help?
In a seizure state, the child needs urgent help.
Parents should immediately call an ambulance, not forgetting to inform the dispatcher by phone that the child has a false croup - this will speed up the arrival of the brigade.
Next, you need to take the child in your arms, try to calm him down - he doesn't need excess excitement now, since it leads to spasms of the larynx. It is enough that the baby is frightened by his very unusual state, in which he cannot, as always, take a normal deep breath.
The apartment urgently needs to organize air access - to open everything that can be opened, regardless of the weather and season. If possible, it is better to take the child out into the street and wait there for the arrival of the "ambulance".
In case of severe edema, an age-related antihistamine can be given. Suprastin will do. There will be less laryngeal edema for a while
You need to understand that repeated attacks are usually more severe and faster, and therefore the help of a doctor is required.
How to treat?
All over the world, according to Evgeny Komarovsky, they try to carry out the treatment of false croup at home. Hospitalization as such is a great stress for a child, especially if he is taken to a hospital without a mother, and the baby is shown calmness. In Russia, a slightly different approach, although recently it has begun to change, more and more approaching world practice.
Yevgeny Komarovsky claims that doctors in our country prescribe too many unnecessary drugs, sometimes ignoring those that are really necessary.
So, the use of antibiotics, antiviral drugs is unreasonable and ineffective, and expectorant drugs are of little help. But anti-inflammatory hormonal agents in the form of drops for inhalation help very well. It is very effective, in just a few minutes, to relieve laryngeal stenosis by inhalation with adrenaline.
At home, parents must create the most appropriate conditions for the child to recover. At any cost Komarovsky urges to humidify the air to 60-70%, and also to make sure that the room is cool (no higher than 20 degrees). Inhalation is acceptable, but with steam or saline.
Neither the essential substances loved by mothers, nor herbal remedies should be used: they can worsen the condition.
With an average degree in a hospital, corticosteroid hormones are used. Inhalation with adrenaline also helps to relieve the danger.
Severe forms often require intensive care in a specially equipped ward in a hospital. Ten percent of children in grade three and four require endotracheal intubation. In rare cases, there is a need for an operation - a tracheotomy. It should be noted that any ambulance paramedic can perform a tracheotomy right at home using improvised means to save a life.
Dr. Komarovsky talks about how to treat false croup in the next video.
