Background: Observation is necessary following racemic epinephrine (RE) for patients with croup. The ideal length of this observation period is unclear.
Objective: To compare the rate of failed outpatient management utilizing different observation times after RE administration for croup.
Methods: We performed a retrospective chart review of children with croup who required RE. Failure of treatment was defined as requiring a second RE treatment and/or returning to the pediatric emergency department for croup symptoms within 24 hours of discharge.
Results: The primary analysis considered patients observed between 2.1 and 3 hours compared with those observed for 3.1 to 4 hours. The patients in the 2.1- to 3-hour group had a higher rate of treatment failure (16.7% vs 7.1%, OR = 2.44, P < .01).
Conclusions: Patients requiring RE for croup are more likely to have treatment failure if observed for between 2.1 and 3 hours as opposed to 3.1 to 4 hours.
Keywords: emergency medicine; general pediatrics.