Croup OSCA

Check for dangers, ensure scene safety. PPE donned

Introduce yourself - name and role

Paediatric Assessment Triangle - assess tone, lookaze, consolability, speech, interactiveness

Identify barking cough, increased WOB, time critical.

Gain consent to assess and treat from child and mother

Ask patient's name

Position patient upright for easier breathing

Airways - state observations - a) stridor, b) lethargy, c) drooling

Send for ICP - in case of additional airway management such as potential tubing

Assess breathing - RATES (AND rhythm) - expose chest

Physical breathing observations - positioning, retraction (intercostal muscles), head bobbing, gasping, grunting, nasal flaring

IF Saturations under 94% - Oxygen - 15L high-flow non-rebreather

Consider dexamethasone - check CPM first. Check for general allergies (say "no contraindication"), then confirm croup as a positive indication.

Mention bodyweight calculation (age + 4 x 2). Then mention dose, 600microg/kg PO. Ampoules come in 8mg (8000microg) in a 2ml vial. Confirm with partner - TREEDEAR - time, reason, education, expiry, documentation, evaluation, assessment, refusal. Administer orally

Adrenaline - check CPM first. Confirm severe asthma as a positive indication.

After checking CPM, mention dose of adrenaline, 5mg nebulised. Repeat once if required. Confirm with partner - TREEDEAR - time, reason, education, expiry, documentation, evaluation, assessment, refusal. Administer in neb

Reassess breathing - RATES, physical breathing observations - positioning, retraction (intercostal muscles), head bobbing, gasping, grunting, nasal flaring

Assess physical circulation signs - pallor, mottling, waxy appearance, cyanosis, obvious bleeding

Circulation observations - palpate pulses, cap refill, HR, B/P, 4-lead

Skip IV access, assess disability - GCS, Temp, BGL, Pupils

Exposure - remove clothes, control for temperature