Safety and efficacy of nebulized racemic epinephrine in conjunction with oral dexamethasone and mist in the outpatient treatment of croup

Ann Emerg Med. 1995 Mar;25(3):331-7. doi: 10.1016/s0196-0644(95)70290-3.


Study objective: To identify patients with croup who after treatment with nebulized racemic epinephrine, oral dexamethasone, and mist may be safely discharged home after a period of observation.

Design: Prospective interventional.

Setting: Urban children's hospital emergency department.

Participants: Children with croup who received racemic epinephrine for the treatment of stridor at rest.

Interventions: After treatment with .5 mL racemic epinephrine, .6 mg/kg dexamethasone PO, and mist, patients who were assessed as being safe for discharge after 3 hours 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 discharged home after 3 hours of observation. No recurrence of respiratory 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 discharge after 3 hours of observation.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Inhalation
  • Administration, Oral
  • Ambulatory Care*
  • Child
  • Child, Preschool
  • Colorado
  • Combined Modality Therapy
  • Croup / drug therapy*
  • Dexamethasone / therapeutic use*
  • Drug Therapy, Combination
  • Emergency Service, Hospital
  • Epinephrine / therapeutic use*
  • Female
  • Hospitals, Urban
  • Humans
  • Infant
  • Male
  • Nebulizers and Vaporizers
  • Prospective Studies
  • Racepinephrine*
  • Recurrence
  • Water


  • Water
  • Dexamethasone
  • Racepinephrine
  • Epinephrine