Short-term steroid treatment Great Ormond Street Hospital

Short-term steroid treatment Great Ormond Street Hospital

Endotracheal intubation is often needed for airway  control, management of respiratory failure and pulmonary toilet. The origin is spread of infection from the teeth, middle ear or the sinuses. The bacteria most commonly identified are streptococcus pyogenes, staphylococcus aureus, haemophilus influenzae and neisseria species and anaerobes [38-40].

  • If your child’s breathing seems very bad, dial 999 for an ambulance.
  • There was also a reduction in the number of children requiring rescue treatment with nebulised adrenaline of 9% and 12% in those treated with budesonide and dexamethasone respectively.
  • However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.
  • There is no difference in efficacy between oral and intramuscular dexamethasone.
  • Nebulised adrenaline is only used in children with severe and life-threatening croup.

Prednisolone is four times as active as hydrocortisone on a weight for weight basis. In some instances, withdrawal symptoms may involve or resemble a clinical relapse of the disease for which the patient has been undergoing treatment. Too rapid a reduction of corticosteroid dosage following prolonged treatment can lead to acute adrenal insufficiency, hypotension and death (see section 4.4). High doses of corticosteroids impair the immune response and so live vaccines should be avoided (see also section 4.4).

When croup is an emergency

During intubation, a tube is inserted either through a nostril or the mouth and passed down into the windpipe. There is no evidence that allowing your child to breathe in humid air, for example steam from a hot bath or shower in a closed room, will help. The virus can be transmitted through close contact with infected people, as well as contaminated objects and surfaces.

The telltale signs your child has croup, usually caused by a viral infection in the upper airways. However, if your child’s symptoms are severe and they are finding it difficult to breathe, take them to the nearest hospital’s accident and emergency (A&E) department. The risk of hypokalaemia also increases if high doses of corticosteroids are given with high doses of bambuterol, fenoterol, formoterol, ritodrine, salbutamol, salmeterol and terbutaline. The toxicity of cardiac glycosides is increased if hypokalaemia occurs with corticosteroids.

Written by healthcare professionals, checked by parents and carers

Blood pressure and renal function (s-creatinine) should therefore be routinely checked. When renal crisis is suspected, blood pressure should be carefully controlled. Visual disturbance may be reported with systemic and topical corticosteroid use.

If your child has been up in the night coughing, you might be wondering if they could have croup. But it can be worrying to see your child finding it hard to breathe. So here’s what to expect if your child does have croup, and information about when to seek further medical treatment.

Findings on examination will depend on the site of the obstruction. Findings include cough, wheeze, stridor and pneumonia but there may be a normal examination. An inspiratory chest x-ray may be normal, whilst an expiratory film may demonstrate air trapping [27-29].

Social media links

Once a daily dose equivalent to 7.5mg (0.75ml) prednisolone is reached, dose reduction should be slower to allow the HPA axis to recover. Next comes a loud, barking cough—some people say it sounds like a seal barking. In severe croup you will hear a rasping or whistling noise when your child breathes in.

When should I suspect croup?

There is no evidence that corticosteroids result in an increased incidence of congenital abnormalities, such as cleft palate / lip in man. However, when administered for prolonged periods or repeatedly during pregnancy, corticosteroids may increase the risk of intrauterine growth retardation. Particular care is required when considering the use of systemic corticosteroids in patients with existing or a previous history of severe affective disorders in themselves or in their first degree relatives. These would include depressive or manic-depressive illness and previous steroid psychosis.