NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium

A 5-year-old male is experiencing a sudden onset of difficulty breathing, stridor, and a 'seal-bark' cough. His parents state he had a cold for a few days, and his symptoms worsened overnight. He is afebrile. What is the MOST likely cause of his respiratory distress?

  1. ACroup.
  2. BEpiglottitis.
  3. CBronchiolitis.
  4. DAsthma exacerbation.
Show answer & explanation

Correct answer: A. Croup.

The patient's presentation of a 'seal-bark' cough, stridor, and a preceding cold, along with being afebrile, are classic signs of croup (laryngotracheobronchitis). Croup is a viral infection that causes swelling around the vocal cords and trachea.

Why the other options are wrong

  • B. Epiglottitis presents with high fever, drooling, muffled voice, and tripod position, not a 'seal-bark' cough.
  • C. Bronchiolitis typically affects infants, presenting with wheezing, tachypnea, and nasal flaring, not stridor or a 'seal-bark' cough.
  • D. Asthma exacerbation presents with wheezing and difficulty exhaling, not stridor or a 'seal-bark' cough.

Croup (Laryngotracheobronchitis)

Croup is a common pediatric respiratory illness caused by viral infection, leading to inflammation and swelling of the larynx and trachea, characterized by a distinctive 'seal-bark' cough and inspiratory stridor.

  • Typically affects children 6 months to 3 years, but can occur up to 6 years.
  • Often preceded by a common cold.
  • Symptoms worsen at night.
  • Usually afebrile or low-grade fever.

Memory trick: Barking cough + stridor + no fever = Croup's got the scoop!

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