What should you know about croup and epiglottitis?

Croup is swelling around the voice box and windpipe, often producing hoarseness, a barking cough, and noisy breathing in. Epiglottitis is inflammation near the flap that protects the airway during swallowing. It may cause severe throat pain, difficulty swallowing, drooling, a muffled voice, and a child sitting forward to breathe. These signs need urgent attention. Do not try to inspect the throat or press the tongue down. A [Common Cold](/conditions/common-cold/) may cause cough and fever, but it does not explain every serious airway symptom.

Keep the child upright, quiet, and with a trusted adult. Avoid forcing food, drink, or medicine if swallowing is difficult. Do not lay the child flat, examine the throat, or leave them alone. If a clinician has diagnosed croup, follow the individual plan and observe breathing while the child is calm. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) is appropriate for assessment when the child is stable; severe symptoms require emergency services.

Call emergency services immediately for drooling with inability to swallow, severe breathing difficulty, a high-pitched breathing sound, blue or grey lips, sudden worsening, or a child who is becoming drowsy. Do not drive a severely distressed child yourself if emergency support is available. Croup with noisy breathing at rest also needs urgent medical advice, especially if the child is tiring or cannot drink.

Ask which signs indicate upper-airway swelling, how to keep the child safe while symptoms settle, whether observation is needed, and which symptoms mean immediate return. Ask whether a [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) was recommended for the diagnosed problem.