Nebulizer treatments for croup primarily involve epinephrine (racemic or L-epinephrine) for rapid relief of severe swelling and corticosteroids (like budesonide) to reduce inflammation, often combined with oral steroids for moderate to severe cases, with the goal of opening the narrowed upper airway, requiring observation after treatment due to epinephrine's short duration.
- Types: Racemic epinephrine is common, but L-epinephrine (1:1000) is also used and can have a longer effect.
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- Dosing: Often given as 0.5 mL of 2.25% racemic epinephrine or 0.5 mL/kg of 1:1000 L-epinephrine.
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- Observation: Children need several hours of observation (3-4 hours) after treatment to ensure symptoms don't return.
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