Tele-triage for Croupy Cough (Child) - Triage

Audience: adult

Croup is a common respiratory condition in young children that causes a distinctive barking cough, hoarseness, and sometimes noisy breathing. It is usually caused by a viral infection and often improves with home care. Telemedicine can help parents and caregivers assess the child's symptoms, provide advice on managing mild cases, and guide when to seek urgent medical care. However, some signs require immediate in-person evaluation, such as difficulty breathing, stridor at rest, or blue lips. This guide helps you understand when tele-triage is appropriate for a child with a croupy cough and what steps to take before and after a telemedicine visit. It also highlights warning signs that need urgent attention to ensure your child’s safety.

Red flags — go in person / ER

• Child has difficulty breathing or is breathing very fast — seek emergency care immediately.
• Stridor (a harsh, high-pitched sound) is present when the child is calm or at rest — get urgent medical evaluation.
• Lips or face appear blue or pale — call emergency services without delay.

What telemedicine can do

• Assessment of mild croup symptoms such as barking cough and mild hoarseness.
• Providing guidance on home care and symptom monitoring.
• Determining when in-person evaluation is needed.

What telemedicine cannot do

• Severe breathing difficulty or respiratory distress.
• Stridor at rest or persistent noisy breathing without crying.
• Signs of low oxygen such as blue lips or altered consciousness.

What is Croup?

Croup is an infection that causes swelling around the vocal cords and windpipe in young children. It often leads to a distinctive barking cough, hoarseness, and noisy breathing called stridor. Symptoms usually worsen at night and improve with cool or moist air. Most cases are mild and get better within a week.

When to Use Telemedicine for Croup

Telemedicine can be useful for evaluating mild symptoms, such as a barking cough without breathing difficulty or fever. A healthcare provider can guide you on home care, hydration, and monitoring. It is a convenient way to get advice without leaving home, especially when symptoms are stable.

When to Seek In-Person Care Immediately

If your child shows signs of severe breathing difficulty, such as fast or labored breathing, stridor at rest (noisy breathing without crying), blue or pale lips, or extreme lethargy, seek emergency care right away. Also, if your child is younger than 6 months or has a weakened immune system, in-person evaluation is important.

Preparing for a Telemedicine Visit

Before your tele-visit, have the following ready: your child's age and weight, a clear video or audio connection, a quiet room, a list of symptoms and when they started, any medications given, and a way to measure breathing rate or observe breathing effort if possible.

After the Telemedicine Visit

Follow the healthcare provider’s advice on home care, such as using humidified air or fever reducers. Monitor your child closely for worsening symptoms. Keep emergency contact numbers handy and know where to go if symptoms escalate. Schedule follow-up if recommended.

How to prepare for your tele-visit

• Ensure a stable internet connection and device with video capability.
• Have your child's recent symptom details ready, including onset and changes.
• Know your child's age and weight to help the provider assess severity.
• Prepare a quiet, well-lit space for the consultation.
• Have a thermometer and watch or timer to measure breathing rate if possible.

After your tele-visit

• Follow the provider’s advice on symptom management and medications.
• Keep your child calm and hydrated.
• Use cool mist or humidified air to ease breathing if recommended.
• Watch closely for any worsening symptoms or new red flags.
• Contact healthcare immediately if red flags develop or symptoms worsen.

FAQs

What causes croup in children?

Croup is usually caused by a viral infection that leads to swelling around the vocal cords and windpipe, resulting in the characteristic barking cough and noisy breathing.

Can I treat croup at home?

Mild croup often improves with home care such as keeping your child calm, using humidified air, and managing fever. However, you should monitor for any signs of breathing difficulty and seek medical advice if symptoms worsen.

When should I go to the emergency room for my child’s cough?

Go to the emergency room if your child has trouble breathing, stridor at rest, blue or pale lips, extreme sleepiness, or if they are very young (under 6 months) and symptoms are severe.

Is croup contagious?

Yes, croup is caused by viruses that can spread through coughs, sneezes, or close contact. Good hand hygiene and avoiding close contact with sick individuals can help prevent spread.

Can telemedicine replace in-person visits for croup?

Telemedicine can help assess mild symptoms and guide care but cannot replace in-person evaluation for severe or worsening symptoms. Always seek in-person care if red flags appear.

Sources

1. Croup — MedlinePlus, U.S. National Library of Medicine.
2. Croup: Symptoms and Causes — 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 professional in-person medical care. If your child has severe symptoms or you are concerned about their health, seek immediate medical attention.