What is the initial intervention for a child with croup exhibiting stridor?

• A. Administer epinephrine inhalation
• B. Administer corticosteroids
• C. Provide cool humidified air or mist therapy and assess for stridor improvement
• D. Supplemental oxygen via nasal cannula

Answer: (C)

In croup, the first move is a noninvasive, supportive approach to calm and moisten the upper airway. Providing cool humidified air or mist therapy helps loosen secretions and reduce mucosal edema, which can lessen stridor and respiratory effort. The key is to start this therapy and watch closely for how the stridor responds over the next several minutes. If you see improvement, continue with supportive care and proceed with standard treatments like a corticosteroid to reduce inflammation. If there’s little or no improvement or the child’s distress worsens, you would then escalate to more targeted interventions such as nebulized epinephrine and further airway management as needed, along with ensuring adequate oxygen if drops in saturation occur.