Date Published

December 20, 2013

Updated For

ALS PCS Version ALS PCS Version 5.2


Question: Multi-part question on croup. I've heard that croup is becoming more prevalent in older children (8 years & up). What is the incidence of croup in older children, and how would their treatment differ in the ER from the < 8 year old group?


 Thanks for the question. Although the OBHG ALS companion guide makes reference to croup occurring in older children and adults and the existence of a few case reports in the literature of croup occurring in adults, this is a VERY rare occurrence and one you will unlikely encounter.


  • Beckwith SR. (2008). A case of adult croup. Intern Emerg Med 3(4) 387-9
  • Woo PC et al. (2000). Adult Croup: a rare but more severe condition. Resp 67(6) 684-8.

In children greater than 6 years, the etiology of stridor is more likely to be caused by something other than croup. According to UpToDate: Croup most commonly occurs in children 6 to 36 months of age. It is seen in younger infants (as young as three months) and in preschool children, but it is rare beyond age six years. It is more common in boys, with a male:female ratio of about 1.4:1.


  • Woods, C.R.(2013). Clinical features, evaluation, and diagnosis of croup. In M.Torchia (Ed.), UpToDate. Available from
  • Cherry JD. Clinical practice. Croup. N Engl J Med 2008; 358:384.
  • Bjornson CL, Johnson DW. Croup. Lancet 2008; 371:329.
  • Segal AO, Crighton EJ, Moineddin R, et al. Croup hospitalizations in Ontario: a 14-year time-series analysis. Pediatrics 2005; 116:51.
  • Rosychuk RJ, Klassen TP, Metes D, et al. Croup presentations to emergency departments in Alberta, Canada: a large population-based study. Pediatr Pulmonol 2010; 45:83.



Keywords are not available for this question at this time.

Additional Resources

No additional resources are available for this SWORBHP Tip.