Back to basics – there is a debate about the volume in the nebulizer cup to achieve appropriate aerosol. When administering 2.5mg of epi for croup or 2.5mgs of salbutamol for bronchoconstriction is it not best practice to add 2.5mls of saline to achieve appropriate aerosol? My co-workers and I are split on this debate.

Can I give a pediatric patient some juice, with their dexamethasone, to make it more palatable? I see this done in-hospital.

How long after someone took an oral steroid (example prednisone) would be contraindicated for giving dexamethasone within the Bronchoconstriction Medical Directive? The Croup Medical Directive is clear that steroids must not have been taken within the past 48 hours. But, the Bronchoconstriction Medical Directive only says, “Currently on PO or parenteral steroids”. What is considered Currently on – taken within the last 24 hours?

With regard to the croup protocol, I am looking for clarification on the indication of “history of URTI.” Does this need to be diagnosed in hospital, or can recent symptoms of an URTI be enough? If the symptoms are enough, how long should the patient present with them for it to qualify as an URTI?

Is there a pharmacological benefit to administering dexamethasone PO vs IV/IM or is it the preferred route simply to avoid unnecessary sharp use?