• C A Ledwith, L M Shea, and R D Mauro.
• Section of General and Emergency Pediatrics, Children's Hospital, Denver, CO.
• Ann Emerg Med. 1995 Mar 1; 25 (3): 331-7.

Study ObjectiveTo identify patients with croup who after treatment with nebulized racemic epinephrine, oral dexamethasone, and mist may be safely discharged home after a period of observation.DesignProspective interventional.SettingUrban children's hospital emergency department.ParticipantsChildren with croup who received racemic epinephrine for the treatment of stridor at rest.InterventionsAfter treatment with .5 mL racemic epinephrine, .6 mg/kg dexamethasone PO, and mist, patients who were assessed as being safe for discharge after 3 hours of observation were discharged home and contacted for 48-hour follow-up.ResultsFifty-five patients with croup were treated with racemic epinephrine. Thirty patients (55%) had sustained responses and were discharged home after 3 hours of observation. No recurrence of respiratory distress and no return visits for medical care were reported (95% confidence interval, 0% to 8.0%).ConclusionPatients with croup who are treated with racemic epinephrine, oral dexamethasone, and mist may be safely discharged home if the patient is assessed as ready for discharge after 3 hours of observation.

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