Thursday, May 14, 2009

Midnight Panic

Last night I awoke to the scariest sound ever, my youngest son was trying to get a breath and struggling to do so. It sounded like choking, he was crying and drooling everywhere. Just like that panic alert set in.
My husband and I got to him at the same time (my husband was still up, it was just midnight). Both of us have our first aid/CPR current so we knew that as long as he was crying, his airway wasn't completely blocked, but we also knew that this wasn't right either. I took our boy, my husband took the phone and dialed 911.
We couldn't see any obstruction and had no idea what was going on. He had been perfectly healthy and happy going to bed 4 and a half hours earlier. Fortunately, the firefighters (yes, they got to us first) were there within minutes and the paramedics were not far behind. As soon as they heard his choking noises they knew what the culprit was, croup.
I remember reading about croup, but this was our first experience with it. If you haven't ever heard it before it sounds like the scariest thing. Your child is struggling to breathe and making noises that sound like a seal barking. Our boy was also gag-coughing, as if he has something caught in his throat (like a cat with a hairball).
We've learned a lot about croup in the last 24 hours. It is a viral infection that causes swelling near the vocal chords. It can and does come on as quickly as that, in the middle of the night, which is scary for both parents and their child. Croup often hits children under 5 as their airways are quite small.
Both the doctor in the emergency department and the paramedics were quick to reassure us that although croup is common among children, never hesitate to get your child seen. Croup can become serious and the earlier it is diagnosed and treated, the better. Our son was given a dose of ventenlin in the ambulance, which helped his breathing. He was also given a dose of corticosteroids at the hospital, which counteracts the swelling. The rest of the things that can be done to treat croup can be done at home. They include:
-using a humidifier in the room
-staying calm, and calm and distract your child - use a story, favorite video, rock in the rocking chair and speak softly to your child - crying only makes the croup cough worse - the paramedic noticed Elmo on my son's jammies and started to talk to him about Seasame Street which got his attention and eased his crying off
-take a walk in the cool night air (bundle him up in a blanket)
-offer fluids, including soups and freezer pops
-hold your child upright - the doctor told me it wasn't neccessary for him to be propped up while sleeping, but being held upright when he's coughing will help ease the cough
-sleep in the same room as your child so that you can get to them quickly and hear what is going on (croup coughs often happen in the middle of the night - our son is camping out in our bed for the next few days just in case)
*note - cough medicines do not help with croup and should not be given, most medicines are not reccommended to be given to children under 6 anyway
Signs that are troublesome and show that you need to get your child seen (or re-seen) include:
-funny whistling breathing noises (both in and out struggling for air)
-high fever (often fever accompanies croup, but anything over 103* F or 39.7*C is too high)
-showing the ribs when breathing - breathing too hard
-drooling, difficulty swallowing
-starts to look blue
-you cannot get him to calm down and the struggle for air is becoming worse
*call for help immediately if any of these things are happening
The doctor told us that croup runs its course in about 5 days and that the 5th day could be the worst. In my son's case it was caught early enough and mild enough that it probably won't develop into anything serious, but again, he wanted to reassure me to bring him back if it did get worse.
I did call his daycare to let them know. Croup is semi-contagious so it may run through the daycare centre. Our daycare manager called public health who told her that as long as he wasn't running a high fever and was mostly better he could attend daycare. It's always good to let your child's daycare, caregiver or school know if they pick up any illness, just in case. Most care centres and schools have a health policy for each kind of illness so you want to make sure that you are following their guidelines (you don't want other little ones to run ill).
I was extremely impressed with everyone we saw last night, from the firefighters to the paramedics to the nurses to the doctor. Everyone was so wonderful with him. They knew that this was a scary thing for a 2 year old to be going through and they were so gentle and kind to him. Often, we don't take the time to thank those who do their job well and these people really were fantastic, so thank you!
To learn more about croup check this out:
Mayo Clinic: Croup

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