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The medical records of 787 patients admitted with a diagnosis of viral croup between January 1986 and December 1992 were examined. The study was prompted by an observed change in the pattern of admissions to the intensive care unit at a large district hospital during the late 1980s. Changes in the pattern of use of adrenaline and steroids were noted.    An increase in the dose and frequency of administration of steroids and nebulised adrenaline occurred during the years of the study. In 1992 one-third of patients were given nebulised adrenaline on admission. In the same year 87% of patients were given a dose of steroid. Despite an increase in the number of patients admitted with viral croup, there was a marked reduction in the number of patients requiring admission to intensive care or intubation during the years of the study.    This information supports the early aggressive use of steroids and nebulised adrenaline in the management of moderate to severe viral croup.

The Use of Steroids and Nebulised Adrenaline in the Treatment of Viral Croup over a Seven Year Period at a District Hospital