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Lesson

Stridor: Croup vs Epiglottitis vs FBAO

10 min Airway & Breathing Skip to quiz

Objective: Sort stridor into croup-like, epiglottitis-like, and choking — then choose calm positioning and a destination that can finish the airway.

Why This Is Hard

The toddler is barking and the parent wants you to “look in the throat.” AHA PALS and pediatric airway teaching: keep the child in a position of comfort. A forced look can finish the obstruction you have not caused yet.

On this truck
  • Position of comfort — usually in a parent’s lap. Do not lay them flat to “get a better look.”
  • Oxygen if they tolerate it. Blow-by beats a fight that closes the airway.
  • If this might be epiglottitis or bacterial tracheitis, you want an airway-capable pediatric destination, not a clinic.

Field Rules (Education)

  • Croup-like: viral prodrome, barking cough, stridor worse when upset. Keep calm. Steroids/nebs are protocol. Most still sit and ride.
  • Epiglottitis-like: toxic, drooling, tripod, little cough, muffled voice. Do not instrument the mouth. Oxygen as tolerated. Early destination. PALS: do not agitate.
  • FBAO: sudden, no fever, witnessed choking — that is the choking lesson, not a neb.
  • Anaphylaxis: stridor plus hives/wheeze/shock — epinephrine IM first. See anaphylaxis.

Field Pitfalls

  • Tongue blade exam on a drooling tripod child.
  • Laying them flat for a “better” sat.
  • Calling every bark “just croup” when they are toxic and silent.

Practice

60-second drill

Partner: (1) 2-year-old bark, playful, stridor only when crying; (2) 4-year-old drooling, tripoding, no cough; (3) 18-month sudden silent choke at dinner. First move and what you will not do.

Related: FBAO, Pediatric airway.

Sources & Further Study

Named guidelines for further study. They are not clinical orders and do not replace your protocol or medical direction.

Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.

Check Your Understanding

Street decisions from this lesson only. After you check, the key is highlighted. Education practice — not a certification exam.

1. A drooling, tripod child with little cough:
2. Barking cough, playful, stridor only when upset:
3. Sudden silence at dinner with no fever:
4. The parent wants you to “look in the throat.” Best framing:
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