Advice, Experience, regarding Severe Croup - Hospital Treatment

[GypsyOnTour]

(Thankyou for taking the time to read this, and Im sorry its so long!)

CROUP

Hi there :wave:
I was just wondering if anyone could please help with some advice, experience regarding Severe Croup.

Our little boy Mathew, 18 months - just experienced his first case of croup which lasted eight or nine days in which he was hospitalised.
We first visited the Doctor with fluish like symtoms which the Doctor explained was exactly that. (I was a little worried that Matty may have something stuck in his throat as I saw Mathew put something into his mouth when I was hanging out the washing outside) The following day, Mathew started to have a hoarse cough and strange breathing, and so we made another visit to the doctor, who explained Mathew had mild croup and prescribed Prednisolone, just the one dose. When I went to the Chemist, I was questioned about the dosage, and it was exlained that usually Prednisolone is to be taken over a course of three days. I was a little concerned with this information, but trusted the doctors advice. The following day I called Health Direct, as Mathew seemed to be getting worse, and there were no Medical Centre's open as it was a sunday. I explained Mathew was making a really strange whistling noise and was gulping everytime he swallowed just saliva. The nurse advised try using steam from the shower, which we did and helped a little, but if he became worse - to take him to the hospital straight away.
We arrived at the Hospital and waited two and a half hours to be seen by a doctor as there was only one doctor on duty. The doctor did what I felt was a quick assessment of Mathew, and even though I explained my concerns to him, he seemed to dismiss as my being a paranoid first time mum. I mentioned the comments made by the Chemist and that I thought he possibly may have swallowed something, and asked if I should be giving Mathew another does of the Prednisolone. The doctor told me he felt Mathew didnt need it. I just had this gut feeling this was wrong and so I questioned him and clarified his advice not to give it to him. He assured me, that he didnt need it.
We then left, not feeling very supported worried sick about Mathew. After a long drive Mathew finally fell asleep for a few hours but when he woke was worse! He was gasping and even holding his breathe it seemed. We drove straight back to the hospital and while we were at the Triage counter, the same Doctor who had just seen Mathew, walked within a few feet in front of us, looked at us and put his head down and kept walking. I asked for the Doctors name which was given and told that he had just finished his shift.
Altough we were upset that the doctor didnt show concern for Matty, We were relieved, as we would be seeing a totally different Doctor. We waited another three hours, in which many times we asked a number of times, how long the wait would be and if someone could just advise us if it was alright to give him another does of the Prednisolone. The nurse encouraged us to wait for the doctor, but in the end Mathew became so distressed, we thought we would be better of with him at home. The nurse did encourage us to use steam again and so we went home and again used the steam.
This now was around 7pm in the evening, and Mathew didnt seem to be getting better. His coughing fits became so bad he would choke and vomit and his face became red and he couldnt catch his breath. when this happened, it seemed to be forever until he started breathing again! I started yelling for my husband and we ran into our bedroom to try and sit him up, but again the same thing. This time he started to go red then purpleish. At that point we just ran to the car and sped into hospital - with him just wrapped in a towl - us no shoes. We had to keep turning the car light on just to keep him aware and awake as his eyes kept closing and his breathing slowed. We got to the hospital in 10 minutes, faster than what an ambulance would have taken even to arrive at our house!
As soon as we brought him in, the nurses first saw him and took the usual obs ect. It seemed as though the nurse was there and then gone - leaving me alone with matt - my husband had to rush home to turn the stove off! Again Mathew had another choking fit and I ran out into the ward crying for somebody - but the office lady told me eveyone was in surgary with the doctor treating a patient. I was really upset and just tried to keep Mathew calm to prevent him from coughing again.
My husband arrived back started getting angry that he was still not seen to - and demanded help. A nurse finally came by and assured us that Mathew would be receiving some more Prednisolone - which we promptly pulled out of handbag that we brought with us! She advised he would be receiving a similar treatment but would enter the body more quickly and would stay longer. After what seemed like 30 minutes later - Mathew was finally given the first dosage of Prednisolone.

At this stage he was a lot worse and was really distressed and anxious. The nurse called for the doctor and the doctor advised he was to have Adreniline immediately. While the nurse was giving him the Adreniline, he became so dietressed that he projectile vomited over her and myself 3 times in a row. At this stage I was shaking and crying - as I am now - just relaying the experince. My husband was saying no no no someone do something - is this normal - somebody help!! We honestly felt we were going to loose him!! The doctor explained that no this wasnt normal andwas the third severe case at the hospital in four years. He was really concerened, as Mathew wasnt responding to the treatment and so he called for the pediatrician. A nurse then gave Mathew another does of Prednisolone, but as a needle in the thigh. When the pediatrician arrived - she immediatle advised the nurse to administer something else to Mathew - which we have no idea what as we were just trying to deal with him! His breathing was so distressing - his little chest would rise and fall so hard it was horrible to watch. The needle that he received - of which we're not sure what - seemed to calm him and he seemed to stop struggling. He managed to actually lay still in my arms and drifted slightly in and out of sleep - he was so exhausted! The stridor was still very strong - however after monitering him for a few hours, he was able to go to the Childrens Ward. Thankgod I was able to stay with him while he was in hospital! When we were able to go home, we were explained to that he may still have coughing fits especially in the evening and one Pediatrician explained to bring him straight back to hospital, and another advised us to give him another dose of Prednisolone.
That very night I became concerned about the breathing noise that was happening when Mathew was breathing out - which the Health Direct Nurse I'd called on the phone explained this was still very serious and with his coughing - advised me to take him back to hospital. The next day, we were still very concered, and took him back to the GP who advised us to give Mathew another 3 does of the Prednisolone over the next three days. We did this, and Mathew seemed to get much better!! We were so relieved!!

Now that Ive explained what happened - I was just wondering if any one else have had the child experience croup and what do u do!! what should we do next time - even to prevent it - as the pediatrician explained that he will most likely get it again and again in the next few years. What treatment helps best and how should we deal with doctor and treatment next time?? We just felt so angry with outselves that we just didnt give him the second does of Prednisolone the next day - and all of this could have been prevented! We blame ourselves for the trauma he went through - but we were too scared to give him the medication against the advice of the doctor! Have we over reacted to the whole experience - or should we follow through with the complaint we have made against the hospital. It is currently being investigated and we are hoping to have a meeting with the doctors involved - so we have a better understanding of Mathews treatment that night or lack of we feel. A couple of my friends have told us that the next time we go back to the hospital to say that Mathew is our second or third child so that we are taken seriously. Hopefully fingers crossed we wont need to go back! :fingerscrossed:

Does any body know through experience or knowledge - what the procedure if for children with severe croup and how should it be managed and its treatment? We are about to pack up and move back to Perth - we just too scared to stay in case it happens again and it might be too late.

Im so sorry this is long! I just so needed to vent my anger! If any body could help we would be so grateful! Thankyou in advance! :)

Warm regards
Jude

[five]

Hi there, Jude, and big :hugs: to you, omg how frightening and distressing for you all, some hospitals just need a good kick up the backside sometimes grrrr.
If I were you I would be demanding your GP refer you to a paediatrician asap, so that Matty can be regularly monitored. Your story sounds very much like what happened with my nephew as a bubba, and after several trips just like you've described someone finally thought to run tests and it turned out he had laryngomalacia, which is basically a floppy airway, so anytime it was even sligthly irritated, it became an emergency as he struggled to breathe.
If there is a next time before you see a paed, don't let them fob you off, you know your baby better than anyone, and just because they haven't taken more than 2 seconds to glance at hom and check that he has not gone blue does not mean he is not in danger. Insist on being seen asap, insist on his oxygen levels being monitored whilst you wait to be seen by the doctor, becuase once that alarm goes off cos the O2 levels have dropped too far, they move pretty quick then ;)
Once upon a time I also used to trust doctors, and think they were almost God-like, but not anymore, and I will not take No for an answer after nearly losing my son too many times, as well as almost dying myself through negligence. there is no excuse for doctor's to be slack, and you should not take any either.
Good luck, and I'm happy to chat further with you anytime :hugs:

[sugar n spice]

my son had severe croup when he was 9 mnths old last year. it was the worst my dr had seen and said it wasnt normal/ he had been treated with the steroids but did not improve much. so i my opinion if your son was similar to mine wether you gave him that second dose or not would not have made much difference. We had been back and forth to the hospital and drs and given dose after dose of steriods with not much improvement in the end i went back to the drs due to the severity of his strider and my dr told me to immedietly go to the hospital where he met me and they gave him the adrenilne which was amazing helped dramatically. he was still in hopsital for a wk to be monitored. The also did a chest x ray as it was so severe my dr was concerened he could of swallowed something. it came back clear but i was so lucky to have a thorough dr that he has now become my kids dr. My son actua;;y has croup now and so i am taking him to the drs this afternoon but it is no where near as bad as it was7 mnths ago.

The best way to make them comfortable is a heater making sure there nice and warm as the cold air just makes it worse, raise there head if possible. a vapouriser is a good start and panadol if needed.

Your child will get it again and again prob and hopefully not as severe. My oldest also suffers from croup though never as bad as his little brother but he is nearly 5 and just got over a bout of it. As they get older it doesnt last as long and usually doesnt need steriods as there airways have got larger.

Im glad things are better now but i do think you are right to make that complaint formal :hugs: to your son and your dh

[Ky]

My dd had terrible croup as a little one and at 5 still gets it mildly.

We used to try putting her in a steamy room, gave her predisone and liquid ventolin, took her to the doc daily to go on the nebuliser, but none of this worked ... we were on the verge of having her admitted for a hospital stay when one of the docs told us of his experience.

He told us that the families that couldn't afford a car or taxi to get them to the hospital would rug thier child up in blankets and walk. By the time the bub was at hospital, thier breathing was eased significantly meaning no need for drugs, just observation for a while. It is thought that the cold air (where we lived in NZ it would be down to minus 2 deg most nights in winter) reduced swelling in the bronchii making it easier for the child to breathe!

I now take my dd outside all wrapped in a blanket if she is croupy ... we will either sit outside and talk about the stars or go for a walk and I try to distract her. It usually only takes about 20 minutes and she is at the point where she can settle back down to sleep without too much coughing or pain. I also no longer heat my kids bedrooms (they are old enough to control thier own body temp) and just give them heaps of blankets ... this way, they are breathing cold air and it seems to be helping in keeping croup at a milder level.

Anyway ... big hugs to you and your family ... it is pretty harsh when you feel like not enough is being done ... it is your child and as a mother your heart is torn in two every time you see them in pain and helpless to do anything about it! I hope your wee man is getting better by the day and that you don't have to deal with this again this winter!

take care ...

[sugar n spice]

Wow cold air, that contradicts everything i have ever tried and been told by the dr and from my experience hasnt helped when there rooms have been cold but it is something i might consider next time, sometimes you need to try everything

[GypsyOnTour]

Hi everyone! A big thanks for all your advice and support
Sorry its taken sooooo long to reply! Mattys been keeping me on my toes after this scare! So far we havent had the croup come back :fingerscrossed:
We've been watching him like a hawlk and prepared for anything that might happen - with a bottle of Redipred in the fridge just in case it gets that bad again. Of course not our first method of treatment - steam / cold air etc first....
(Its just there in case we ever are sent home again in the condition he was in)

Since his treatment in hospital - we've received a letter from the Hospital/Area Health Service with a letter explaining their intentions to follow up on our complaint and that we would be informed of the outcome of the investigation.
Its now been two and a half months - and still now contact from the hospital :banghead:

Im not as bothered by this - but has definately made me more aware and has encouraged me to trust my instincts! :)

I will let you all know when and if I hear anything -
once again - thanks everyone for all your help and support! You've been unreal!
Cheers,
Jude :smiliedance:

[skyejax]

hi there my dd suffers croup... thankfully we hav made it this far into the yearwith no episode yet...:fingerscrossed:
sorry to hear about all the trouble u went thrugh. i find a ateamy bathroom or vapouriser in bedroomhelps a little. but not as much as the redipred(same stuff u were given). it doesnt stop the croup however but it does shorten the time they suffer, usuallly only a few days. and yes it is given once daily for three days. my dr told me though that u can safely give it for up to a week(my dd had it realy bad last year), but only on drs advice, so if not better in say 2/3days to come bak see him and he would decide if she should go longer. which she did, she ended up taking it for 6days straight.
anyway good luck, and the best advice i acn give u is to try and stay as calm as possible(hard i know, first time dd had it i thought she as going to choke) your bub will feel it if u r paniking and they will panik more

[pookiesossige]

Hey there- I felt sad reading your post, your son (and you and your DH) should have recieved much better treatment then that :hugs: . What an awful ordeal.
My DS has been in hosp with croup three times but didn't need to be admitted to the children's ward thank goodness. Every time it was quite severe though and he required both adrenaline and steriodal injections- I think that this could have been the injection into your son's thigh.
The good news is that croup after age 3 is very rare. We were also told by all medical practitioners that cold air is the go for croup- it helps the muscles in their windpipe shrink back and facilitate easier breathing. We had the windows down a little bit on the way to and from hospital, at the reccommendation of the paed and gp.