Red flags & when to go in person for Croup - Triage

Audience: pediatric

Croup is a common respiratory condition in young children that causes a barking cough and sometimes noisy breathing. It often improves with home care, but some signs mean your child needs to be seen by a healthcare provider in person. This guide helps parents and caregivers recognize red flags that require urgent evaluation. Telemedicine can support initial assessment and advice for mild cases, but cannot replace emergency care when breathing is hard or the child looks very unwell. Knowing when to seek in-person care helps keep your child safe and ensures timely treatment. Always trust your instincts and seek help if you are worried about your child's breathing or behavior.

Red flags — go in person / ER

• Difficulty breathing with fast breaths or chest pulling in — go to emergency care immediately.
• Stridor (noisy breathing) at rest or when calm — seek urgent medical evaluation.
• Blue or gray lips or face — call emergency services or go to the nearest emergency department immediately.

What telemedicine can do

• Initial assessment of mild croup symptoms.
• Providing advice on home care and symptom monitoring.
• Answering questions about when to seek further care.

What telemedicine cannot do

• Evaluating severe breathing difficulties.
• Diagnosing complications like bacterial infections.
• Providing emergency treatment for airway obstruction.

What is Croup?

Croup is an infection that causes swelling around your child's voice box (larynx), windpipe (trachea), and breathing tubes (bronchi). It often starts with cold-like symptoms and leads to a distinctive barking cough and hoarse voice. Croup mostly affects children between 6 months and 3 years old.

Common Symptoms of Croup

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Most children with croup can be cared for at home with rest, fluids, and cool mist.

When to Seek In-Person Care

Watch for these red flags that mean your child needs urgent medical evaluation:

If you notice any of these, take your child to the nearest emergency department immediately.

How Telemedicine Can Help

Telemedicine can be useful for:

However, telemedicine cannot replace a physical exam when breathing is difficult or your child looks very sick.

Preparing for a Telemedicine Visit

Before your tele-visit:

Aftercare and Monitoring

After your telemedicine visit:

How to prepare for your tele-visit

• Measure and note your child's temperature.
• Observe and be ready to describe your child's breathing pattern.
• Have a quiet, well-lit area for the video call.
• Prepare a list of symptoms and when they started.
• Have any medications or treatments used available to discuss.

After your tele-visit

• Follow provider's instructions on home care.
• Keep your child calm and hydrated.
• Use recommended humidification methods if advised.
• Monitor for worsening symptoms or red flags.
• Seek emergency care if danger signs appear.

FAQs

What causes croup in children?

Croup is usually caused by a viral infection that leads to swelling around the voice box and windpipe, making breathing noisy and causing a barking cough.

Can croup be treated at home?

Mild croup often improves with home care such as keeping your child calm, hydrated, and using cool mist. However, watch for warning signs that need medical attention.

When should I take my child to the hospital?

If your child has trouble breathing, noisy breathing at rest, blue lips, drooling, or extreme tiredness, seek emergency care immediately.

Is croup contagious?

Yes, croup is caused by viruses that can spread through coughing, sneezing, or close contact with infected individuals.

Can telemedicine diagnose croup?

Telemedicine can help assess symptoms and advise on care but cannot replace a physical exam when breathing is severely affected or emergency treatment is needed.

Sources

1. Croup — MedlinePlus, U.S. National Library of Medicine.
2. Croup (Laryngotracheobronchitis) — Mayo Clinic.
3. Croup — Centers for Disease Control and Prevention (CDC).
4. Croup in Children — American Academy of Pediatrics.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child shows any danger signs or you are concerned about their health, seek immediate medical attention.