Feature Article

Acute upper airways obstruction in children

Gary C Geelhoed



Croup will be encountered by all GPs and is generally easy to treat. However, careful assessment is essential to exclude sinister causes of obstruction and prevent progression of a ‘typical’ case to a life threatening situation.

Key Points

  • Acute upper respiratory obstruction in children is common and is usually caused by croup.
  • Almost all children who present with croup will benefit from a one-off dose of oral corticosteroids.
  • Adrenaline is useful for more severe cases of croup. However, its effects are short lived and it does not change the natural history of croup.
  • The possibility of other problems should always be kept in mind, and will often be uncovered by a complete history and examination.
  • Other causes should be considered in any child who has severe symptoms, does not respond early to treatment, or has a prolonged course.