All three cause breathing trouble in young kids, and exams love to mix them up. The biggest difference: epiglottitis is an emergency where the airway can close.
Side by side
| Croup | Epiglottitis | Bronchiolitis | |
|---|---|---|---|
| Usual cause | Virus (often parainfluenza) | Bacteria (classically Haemophilus influenzae type b) | Virus (most often RSV) |
| Typical age | 6 months to 3 years | Any age, classically 2 to 6 years | Under 2 years |
| Onset | Slow, after a cold. Worse at night. | Sudden, with a high fever | Runny nose first, then cough |
| Key signs | Barking, seal-like cough, hoarse voice, stridor | Drooling, trouble swallowing, muffled voice, sitting forward (tripod) | Wheezing, crackles, nasal flaring, retractions, trouble feeding |
| Nursing care | Keep calm, cool humidified air, steroids (dexamethasone), racemic epinephrine for stridor at rest | Keep the child calm and upright, have airway equipment ready, call for help | Suction the nose (especially before feeds), oxygen if needed, fluids, contact precautions |
Never do this in epiglottitis
- Do not look in the throat or use a tongue depressor. It can trigger a complete airway blockage.
- Do not make the child lie down or leave their parent's lap.
- Do not take a throat culture at the bedside.
Memory trick
Epiglottitis has the 4 Ds: drooling, dysphagia (trouble swallowing), dysphonia (muffled voice), and distress.
Practice question
A 4-year-old arrives with a high fever, drooling, and sitting forward. Which action should the nurse avoid?
- Keep the child on the parent's lap
- Inspect the throat with a tongue depressor
- Have emergency airway equipment ready
- Keep the child calm
Show answer
B. These signs point to epiglottitis. Examining the throat can cause the airway to close completely.
Practice this in Head-to-Toe
Listen for stridor, wheezes, and crackles in real-feeling patients.
Play Head-to-ToeFree account to start. Every game free for 14 days.
Quick answers
What is the difference between croup and epiglottitis?
Croup is usually viral, comes on slowly, and causes a barking cough. Epiglottitis is bacterial, comes on suddenly with a high fever and drooling, and is an airway emergency.
Why should you not examine the throat in epiglottitis?
Using a tongue depressor can trigger spasm and complete airway blockage.
Evidence & Clinical Sources
- AAP Clinical Practice Guideline: Bronchiolitis (Pediatrics, 2014)
- Hockenberry, Wong's Essentials of Pediatric Nursing, Elsevier
- American Academy of Pediatrics
Reviewed against current guidelines and drug labels. Always follow your program, a current drug reference, and facility policy. Our sources policy
For learning only. Lab ranges and policies vary. Always follow your nursing program, a current drug reference, and your facility's policies.