Is Albuterol a treatment for croup?

Answer 1

I found it confusing as my older son was always prescribed albuteral along with prednizone for the croup. I had a 2nd child 7 years later. He had the croup and the urgent-care center gave him the same. He got worse so I took him the Syracuse University Pediatric Emergency room. The staff look at me in horror when I told them albuteral/predizone were prescribed. Their reaction was almost as if I was prescribed poison. I asked why such a different opinion in treatments. "They said that albuterol and prednizone was the old version of treatment." There are better more effective meds now available The walkin's physician was old so maybe not up to speed. They gave me nothing to treat the croup because they said the worst was over. FYI: 7-9 years ago Hospital locations that treated my older son for croup; Alameda California, Los Angeles California, Albany New York, Phoenix Arizona and Springfield MA. Pediatricians that did the same in Phoenix, AZ and Albany, NY. I don't know what to say. I used the albuterol again because that is all I had. I also used the steam in the shower. It calmed him and he could sleep. He stayed somewhat alseep for 3.5 hours and had another attack. I repeated the routine and he is sleeping again. I have been getting a lot of search hits lately for the search "Croup and Albuterol." To justify my presence on the search engines, here's my opinion on it, but first here is a disclaimer: I am not a physician. I am no longer a practicing Respiratory Therapist. Take any advice here with a huge grain of salt and remember to consult a real doctor before you make any decisions about anything. Moving on.

Croup, which we all know and love as that barky sound that kids make, is caused by swelling in the airway. The trachea and air passages are swollen and inflamed, and it makes kids feel tight and wheezy and sound scary.

Albuterol is an overprescribed Beta-2 agonist. It works very well for bronchospasm, and is sometimes used to lower serum Potassium. But that is all it does. Read this again: it is a BRONCHODILATOR. It does not cause swelling to go down: it causes the bronchioles to dilate if the muscles that control them are tightening up. I cannot emphasize enough that it does NOT reduce swelling: it simply relaxes the smooth muscles around the bronchioles.

Now, let's apply logic: bronchodilators work when someone has bronchospasm, usually asthmatic or emphesematic in nature. Croup is a problem with swelling in the airways. It is not a problem of bronchospasm, although it can cause it in asthmatic children. Albuterol will NOT....repeat, NOT...cause airway swelling to go down. Racemic Epinephrine, the usual prescription for croup, will cause airway swelling to go down.

So is it smart to use albuterol for croup? No. Unless the child with croup is asthmatic or has a history of some sort of RAD, it is unacceptable and bordering on malpractice to prescribe albuterol for croup. Racemic epinephrine and steroids will cure croup. Albuterol will not.

To conclude, I would just like to say this: the only physicians I have ever seen prescribe albuterol for croup on a routine basis have been, without exception, ignorant, old-school, unchanging buffoons who should not be practicing medicine in the first place because it's been thirty years since the bothered to read a medical journal. Seriously, these guys are the kind of doctors who are likely to order trepanning and bloodletting for headaches and infections.

Albuterol is NOT a cure-all. Do not prescribe it unless the child has Asthma. It will do nothing and it will make the respiratory therapist despise you and think you are an idiot. End of discussion.

Answer 2

not a hot vaporizer, but a cool mist humidifier also will help with getting the swelling down. Cold air also helps relieve stride.