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Pediatric Stridor

Date Last Search Run: Feb 01, 2026
Table last updated: Nov 26, 2025
Data last added: Nov 16, 2025

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)      
2 (fair evidence exists)  
3 (weak evidence exists)    


Interventions

Epinephrine-Nebulized
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) variation in RE use between ED Process ED-MD Walsh PS, Zhang Y, Lipshaw MJ. Variation in Emergency Department Use of Racemic Epinephrine and Associated Outcomes for Croup. Hosp Pediatr 2023; 13(2):167-73. Medline
III Supportive (Green) DC from ED Process ED-MD Ledwith CA., Shea LM., Mauro RD. Safety and efficacy of nebulized racemic epinephrine in conjunction with oral dexamethasone and mist in the outpatient treatment of croup. Ann Emerg Med 1995; 25(3):331-337. Medline

Hypertonic Saline-Nebulized
Level Direction Primary Outcome Patient/Process Setting Reference

Oxygen
Level Direction Primary Outcome Patient/Process Setting Reference

Oxygen-Humidified
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) LOS Patient PH-Paramedic & MD Yap C, Withers A, Ghedina N, O’Connell E. Evaluating the Introduction of Humidified High-Flow Nasal Cannula Therapy Into an Australian Aeromedical Service Within a Paediatric Population: A Retrospective Cohort Study. Emerg Med Australas August 2025; 37(4):e70105. Medline
III Supportive (Green) Discharge from ED Process ED-MD Ledwith CA., Shea LM., Mauro RD. Safety and efficacy of nebulized racemic epinephrine in conjunction with oral dexamethasone and mist in the outpatient treatment of croup. Ann Emerg Med 1995; 25(3):331-337. Medline

Oxymetry Monitoring
Level Direction Primary Outcome Patient/Process Setting Reference

Steroids-Oral
Level Direction Primary Outcome Patient/Process Setting Reference
III Supportive (Green) DC from ED Process ED-MD Ledwith CA., Shea LM., Mauro RD. Safety and efficacy of nebulized racemic epinephrine in conjunction with oral dexamethasone and mist in the outpatient treatment of croup. Ann Emerg Med 1995; 25(3):331-337. Medline


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