What should you know about croup lung sounds?

The croup sound is called stridor. It comes from narrowing around the larynx and upper windpipe, rather than deep in the lungs. It may be easiest to hear when a child inhales, cries or coughs. A barking cough and hoarseness often occur alongside it. A clinician listens to the child and watches the chest, ribs and neck to judge how hard breathing is. A recording can help describe a sound, but it cannot replace an examination when breathing is difficult.

Keep the child quiet, upright and close to a trusted adult. Crying can make the sound louder and increase effort. Offer fluids only if the child is alert and swallowing normally. Check the sound when the child is resting, and note whether the chest pulls in with each breath. Avoid steam and do not give cough medicines or prescription medicines unless a clinician has advised them. A child health consultation can clarify whether treatment is needed; a clinician may use nebuliser treatment for selected breathing problems.

Get emergency help for severe breathing effort, ribs or neck pulling in, pauses, blue or grey lips, collapse, marked drowsiness, or inability to speak, cry or swallow. Seek prompt assessment if stridor continues while the child is calm or resting, becomes louder, or comes with worsening tiredness or poor drinking. A cough that sounds like croup but is accompanied by choking or sudden onset also needs urgent evaluation.

Describe whether the sound occurs on breathing in, breathing out or both; whether it is present at rest; and whether the child has hoarseness, cough, fever or a runny nose. Ask how to measure worsening effort and where to seek help if the sound returns overnight.