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Pathway Background and Objectives

Croup is the most common infectious cause of upper airway obstruction in children, accounting for 15% of all respiratory tract disease in pediatric practice.  3-5% of all children will get croup at some point in their lives, but only 5-10% of these cases are severe enough to require hospital admission.

The objectives of this pathway are to:

  • Improve both emergency department and inpatient croup care through consistent application of current best practice
  • Reduce the frequency of unnecessary testing (viral testing, chest or lateral neck x-rays)
  • Reduce the use of medical interventions which are not evidence-based (antibiotics, albuterol, prednisolone, inhaled corticosteroids, cool mist humidification)


Download Croup Pathway Algorithm

Quality Metrics

  • Percentage of eligible patients treated per pathway
  • Percentage of patients with order set usage
  • Mean length of time from arrival to ED and administration of dexamethasone
  • Percentage of all patients receiving NRIRs (not routinely indicated resources)
  • Percentage of ED patients receiving NRIRs (not routinely indicated resources)
  • Length of stay ED (min) and inpatient (days)
  • Percentage of patients who return to ED within 7 days

Educational Module

Download Croup Educational Module

Key References

Pathway Contacts

  • Christina Giudice, APRN
  • Eric Hoppa, MD
  • Ilana Waynik, MD


The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.

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