Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up study
IntroductionRespiratory illnesses, often caused by upper or lower airway obstruction, represent one of the most common pediatric emergencies. Croup syndrome is the most frequent cause of inspiratory stridor. The study aims to record the incidence, current treatment, and further care measures. Additi...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1544480/full |
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| author | Florian Hey Florian Hey Victoria Lieftüchter Victoria Lieftüchter Martin Olivieri Martin Olivieri Sebastian Zimatschek Florian Hoffmann Florian Hoffmann Daniel Pfeiffer |
| author_facet | Florian Hey Florian Hey Victoria Lieftüchter Victoria Lieftüchter Martin Olivieri Martin Olivieri Sebastian Zimatschek Florian Hoffmann Florian Hoffmann Daniel Pfeiffer |
| author_sort | Florian Hey |
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| description | IntroductionRespiratory illnesses, often caused by upper or lower airway obstruction, represent one of the most common pediatric emergencies. Croup syndrome is the most frequent cause of inspiratory stridor. The study aims to record the incidence, current treatment, and further care measures. Additionally feasibility and suitability of future telemedical consultations for pseudo-croup syndrome should be evaluated.MethodsA prospective observational follow-up study of children aged 0–18 years who were seen by the Munich physician-led prehospital pediatric emergency service from October 15, 2020 to April 30, 2023. The attending emergency physician completed an anonymous questionnaire with treatment information. The child's parents provided a second questionnaire regarding the clinical course and further care in the 12 h following the initial presentation.ResultsA total of 226 patients, 154 (68.1%) with a corresponding parental questionnaire, were analysed. The average age was 3.4 years (range 5 months to 9.5 years), with most patients in the toddler (37.6%; n = 85) and early childhood (45.1%, n = 102) age brackets. 8.4% (n = 19) of patients had a, most frequently respiratory (52.6%, n = 10), chronic precondition. The average Westley Score in our cohort was 4.1. Every year increase in age reduces the average Westley score by 21.2% (p = 0.034). Acute therapy consists of steroids rectally (98.2%, n = 222), adrenaline (85.8%, n = 194) and cold/fresh air (78.8%, n = 178) inhalations. 39.8% (n = 90) of patients were transported to the hospital, and a physician accompanied a third (35.6%, n = 32). The strongest predictor for the necessity of physician-accompanied transport was prolonged adrenaline inhalations (OR: 11.25). Nearly ¾ of patients (70.2%, n = 47) were discharged from the emergency department. Of all admitted patients (n = 20), 10% (n = 2) needed intensive care. Out of all patients (n = 226), in 7% (n = 10) of cases with parental information on reoccurrence, a reoccurrence of the croup attack within 12 h was reported.Conclusion(s)Croup syndrome attacks have a low risk of hospitalisation and rebound. In light of increasingly limited healthcare resources, this study identifies several significant influencing variables for the treatment pathways and proposes a potential treatment algorithm. No patient needed invasive treatments, rendering croup attacks in children a possible target for telemedical consultations with no necessity for on-site physician presence. |
| format | Article |
| id | doaj-art-7d2faf3d6b00477f95b3032fa0b966ac |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj-art-7d2faf3d6b00477f95b3032fa0b966ac2025-08-20T03:53:12ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-05-011310.3389/fped.2025.15444801544480Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up studyFlorian Hey0Florian Hey1Victoria Lieftüchter2Victoria Lieftüchter3Martin Olivieri4Martin Olivieri5Sebastian Zimatschek6Florian Hoffmann7Florian Hoffmann8Daniel Pfeiffer9Department of Pediatric Intensive and Emergency Care, Dr. v. Hauner Children’s Hospital, LMU University Hospital, LMU Munich, Munich, GermanyPrehospital Pediatric Emergency Service, Munich, GermanyDepartment of Pediatric Intensive and Emergency Care, Dr. v. Hauner Children’s Hospital, LMU University Hospital, LMU Munich, Munich, GermanyPrehospital Pediatric Emergency Service, Munich, GermanyDepartment of Pediatric Intensive and Emergency Care, Dr. v. Hauner Children’s Hospital, LMU University Hospital, LMU Munich, Munich, GermanyPrehospital Pediatric Emergency Service, Munich, GermanyPrehospital Pediatric Emergency Service, Munich, GermanyDepartment of Pediatric Intensive and Emergency Care, Dr. v. Hauner Children’s Hospital, LMU University Hospital, LMU Munich, Munich, GermanyPrehospital Pediatric Emergency Service, Munich, GermanyDepartment of Pediatric Intensive and Emergency Care, Dr. v. Hauner Children’s Hospital, LMU University Hospital, LMU Munich, Munich, GermanyIntroductionRespiratory illnesses, often caused by upper or lower airway obstruction, represent one of the most common pediatric emergencies. Croup syndrome is the most frequent cause of inspiratory stridor. The study aims to record the incidence, current treatment, and further care measures. Additionally feasibility and suitability of future telemedical consultations for pseudo-croup syndrome should be evaluated.MethodsA prospective observational follow-up study of children aged 0–18 years who were seen by the Munich physician-led prehospital pediatric emergency service from October 15, 2020 to April 30, 2023. The attending emergency physician completed an anonymous questionnaire with treatment information. The child's parents provided a second questionnaire regarding the clinical course and further care in the 12 h following the initial presentation.ResultsA total of 226 patients, 154 (68.1%) with a corresponding parental questionnaire, were analysed. The average age was 3.4 years (range 5 months to 9.5 years), with most patients in the toddler (37.6%; n = 85) and early childhood (45.1%, n = 102) age brackets. 8.4% (n = 19) of patients had a, most frequently respiratory (52.6%, n = 10), chronic precondition. The average Westley Score in our cohort was 4.1. Every year increase in age reduces the average Westley score by 21.2% (p = 0.034). Acute therapy consists of steroids rectally (98.2%, n = 222), adrenaline (85.8%, n = 194) and cold/fresh air (78.8%, n = 178) inhalations. 39.8% (n = 90) of patients were transported to the hospital, and a physician accompanied a third (35.6%, n = 32). The strongest predictor for the necessity of physician-accompanied transport was prolonged adrenaline inhalations (OR: 11.25). Nearly ¾ of patients (70.2%, n = 47) were discharged from the emergency department. Of all admitted patients (n = 20), 10% (n = 2) needed intensive care. Out of all patients (n = 226), in 7% (n = 10) of cases with parental information on reoccurrence, a reoccurrence of the croup attack within 12 h was reported.Conclusion(s)Croup syndrome attacks have a low risk of hospitalisation and rebound. In light of increasingly limited healthcare resources, this study identifies several significant influencing variables for the treatment pathways and proposes a potential treatment algorithm. No patient needed invasive treatments, rendering croup attacks in children a possible target for telemedical consultations with no necessity for on-site physician presence.https://www.frontiersin.org/articles/10.3389/fped.2025.1544480/fullcrouppediatric emergency medicineemergency medical servicesprehospital/EMSrespiratory diseases |
| spellingShingle | Florian Hey Florian Hey Victoria Lieftüchter Victoria Lieftüchter Martin Olivieri Martin Olivieri Sebastian Zimatschek Florian Hoffmann Florian Hoffmann Daniel Pfeiffer Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up study Frontiers in Pediatrics croup pediatric emergency medicine emergency medical services prehospital/EMS respiratory diseases |
| title | Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up study |
| title_full | Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up study |
| title_fullStr | Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up study |
| title_full_unstemmed | Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up study |
| title_short | Treatment pathways and rebound-rate of prehospital viral croup attacks—data from a prehospital pediatric physician led emergency service—a prospective observational follow-up study |
| title_sort | treatment pathways and rebound rate of prehospital viral croup attacks data from a prehospital pediatric physician led emergency service a prospective observational follow up study |
| topic | croup pediatric emergency medicine emergency medical services prehospital/EMS respiratory diseases |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1544480/full |
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