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Historical review of croup.

In the 1960s, managing croup was simple - put the child in the bathroom and run a hot shower. In most cases, the child's symptoms would be controlled. When the mist from the shower failed to control the croup, the parents would take the child to an emergency room. Often, the child would get better on the way to the hospital, thanks to the cool, outside air. At the hospital, a 'croupette' would be available for some children, and the health care providers hoped that the children would remain quiet in the strange tent filled with cold mist. Some hospitals even had special croup rooms where steam was piped in, and the whole room was filled with cold mist. Needless to say, nursing staff were not eager to work in these rooms. The last resort of treatment was a tracheotomy because the art of intubation had not yet been mastered. Two randomized studies failed to show the benefit of cool mist, and, today, it is rarely used (1,2).