Pediatric Stridor Date Last Search Run: Jan 14, 2025 Table last updated: Sep 16, 2023 Data last added: Sep 13, 2023

Recommendation		RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION		SUPPORTIVE (Green)	NEUTRAL (Yellow)	AGAINST (Red)	NOT YET GRADED (White)
	1 (strong evidence exists)				Hypertonic Saline-Nebulized Oxygen Oxymetry Monitoring
	2 (fair evidence exists)	Epinephrine-Nebulized
	3 (weak evidence exists)	Oxygen-Humidified Steroids-Oral

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
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