Dr. Komarovsky about the croup in children
There are words and diagnoses that frighten parents very much, and this is quite reasonable. One of these diagnoses is croup. Everyone has heard that it is extremely dangerous, but very few people know exactly how to recognize it in a child and how to help the crumbs.
Famous children's doctor Yevgeny Komarovsky tells how to determine the signs of croup and what to do.
What happens?
Children croup is completely different.
Evgeny Komarovsky encourages parents to clearly see the difference between true and false croup.
In both cases, it is a critical narrowing of the lumen of the larynx due to its inflammation and swelling that has developed in the tissues.
In the absence of help and proper treatment, the child may die, either from asphyxiation or from hypoxic damage to the brain and heart.
False croup is more common, it is inherently a complication of any viral disease, most often parainfluenza, adenovirus, influenza viruses of common strains. True or real croup - diphtheria manifestation, which develops against the background of a very specific disease - diphtheria. In this case, the larynx of the baby is not only narrowed due to swelling, but also covered with dense diphtheria films.
In the past, most children with diphtheria died from true croup. And only after the vaccination for this disease has become universal, the problem was managed. Today, cases of diphtheria - a rarity, and only cases of diphtheria, complicated by true croup, and even more so.
Symptoms and signs
Symptomatic picture and with false croup, and with the true is very similar, however, some differences still exist. Parents can be suspected if a child has a viral infection or diphtheria 2-3 days ago. It is through such intervals that the first signs appear - the child has a persistent, dry, barking cough, sore throat. And with false, and with true diphtheria croup, a hoarse voice appears. But when a child is false, the child does not completely lose his voice, which cannot be said about diphtheria.
The nature of breathing changes - it becomes noisy, hoarse, whistling. The stronger the stenosis (contraction), the more whistling the breath becomes. The child has difficulty breathing air. Especially strong wheezing becomes noticeable at the moments when the child cries, and at night.
The fact that the stenosis has reached a severe form is indicated by uncontrolled drooling, shortness of breath, cyanosis in the area of the nasolabial triangle and blanching of the skin. The child may lose consciousness. Due to the inability to make a breath in a normal volume, hypoxic damage of the internal organs develops.
With true croup, the baby almost always has a high fever, fever, and a pronounced state of intoxication. In the throat, you can see a special, dense film film peculiar to diphtheria. It has a grayish tint.
Diphtheria stenosis does not worsen at night, as false croup. So, with him there is no acute reversible attacks of suffocation. In a more or less even mode, he gradually goes into an extremely serious state of the asphyxial uncompensated stage. Loss of voice with real croup leads to the fact that the baby cries and coughs without sounds, in complete silence. The deterioration occurs rapidly, in the absence of qualified assistance, the child in most cases dies.
You can find out how to diagnose croup yourself in the video below.
What to do?
Yevgeny Komarovsky, in the framework of his project “School of Doctor Komarovsky,” has repeatedly stressed that the rules for providing first aid to a child with croup are important knowledge for any mother, since any child may have a false croup.
If the baby does not have diphtheria, then we can talk about false croup. In this case, the mother needs to call an ambulance, calm the baby, because stress and fright because it is impossible to take a normal breath, can increase muscle spasm, and the larynx will close up even more. It is best to open all the windows, the balcony door, or take the child to the air while waiting for the doctor.
No medication is needed. Only one age dose of an antihistamine drug, for example, Suprastin, is acceptable; it will help reduce the laryngeal tissue swelling and wait for the medical team to arrive.
The same first aid rules apply to true croup. If, for some reason, the child after the diagnosis of “diphtheria” has stayed at home (despite the fact that she has been hospitalized in an infectious diseases hospital), then you need to take the baby to the hospital as soon as possible.
A few more tips to help the child with croup - in the next video.
Treatment
If it is preferable to treat false croup at home, in an environment where the baby is familiar, to avoid stress, fright and everything that can lead to laryngeal spasms, then true croup is treated only in a hospital, and there are no other options. The child with diphtheria is sent to the infectious disease ward of the children's hospital.
The only way to save a child is to give him anti-diphtheria serum, which is derived from horse blood. Horses are pre-infected with diphtheria bacillus.
At home, such introductions are unreasonable and criminal for the reason that the serum is very allergenic, and often gives such side effects that they hardly have time to eliminate them in a hospital setting. At home, this is basically impossible.
If the child is very difficult to breathe, he is introduced "Prednisolone”, Besides, they put droppers in order to reduce the manifestations of intoxication, which is essentially poisoning by the products of metabolism of the causative agent of diphtheria. The most dangerous is exotoxin. Throat irrigated with antiseptic solutions. If false croup does not require the use of antibiotics, then they are necessary for diphtheria, since the infection is bacterial.
In the next video, Dr. Komarovsky makes an important recommendation when treating croup in children.
Effects
In most cases, with proper first aid and reasonable treatment, false croup rarely has long-term negative effects and complications. Unfortunately, the same cannot be said about true croup.
Very often, after suffering diphtheria croup, such conditions as pneumonia, otitis media, meningitis develop. And no one needs to blame for this - the quality of medical care in situations related to real croup does not affect the likelihood of complications. But directly affects survival.
If mistakes were made, help came late, did not come at all, a child with true croup may suffocate and die.
How to prevent?
If there are no specific preventive measures against false croup, then the child can be successfully saved from the diphtheria wave.
To do this, parents need to reconsider their attitude to vaccinations, in particular - to vaccination. DTP. It refers to the compulsory vaccination prescribed by the National Calendar in Russia. It reliably protects against diphtheria sticks.
Does this mean that the vaccinated baby does not get sick with this disease? No, does not mean. But such a probability is small, moreover, in children with whom DPT was made, even in case of infection with diphtheria, the disease proceeds more easily, without signs of true croup.
DPT in Russia is done to infants at 3 months, then every two months, twice more.The fourth vaccination is carried out one year after the third, and repeated vaccinations at 6 and 14 years. Refusing such vaccinations means consciously putting the child in great danger.
