Ca. Ledwith et al., SAFETY AND EFFICACY OF NEBULIZED RACEMIC EPINEPHRINE IN CONJUNCTION WITH ORAL DEXAMETHASONE AND MIST IN THE OUTPATIENT TREATMENT OF CROUP, Annals of emergency medicine, 25(3), 1995, pp. 331-337
Study objective: To identify patients with croup who after treatment w
ith nebulized racemic epinephrine, oral dexamethasone, and mist may be
safely discharged home after a period of observation. Design: Prospec
tive interventional. Setting: Urban children's hospital emergency depa
rtment. Participants: Children with croup who received racemic epineph
rine for the treatment of stridor at rest. Interventions: After treatm
ent with .5 mL racemic epinephrine, .6 mg/kg dexamethasone PO, and mis
t, patients who were assessed as being safe for discharge after 3 hour
s of observation were discharged home and contacted for 48-hour follow
-up. Results: Fifty-five patients with croup were treated with racemic
epinephrine. Thirty patients (55%) had sustained responses and were d
ischarged home after 3 hours of observation. No recurrence of respirat
ory distress and no return visits for medical care were reported (95%
confidence interval, 0% to 8.0%). Conclusion: Patients with croup who
are treated with racemic epinephrine, oral dexamethasone, and mist may
be safely discharged home if the patient is assessed as ready for dis
charge after 3 hours of observation.