Emergent ENT consult
O2 (humidified)
IVF (hydration minimizes crusting in the airway)
Avoid attempting IV access in a young child if likely to cause significant agitation and precipitate airway compromise
Nebulized epinephrine to reduce edema
Avoid attempting IV access in a young child if likely to cause significant agitation and precipitate airway compromise
Coverage targets Streptococcus pneumoniae, Staphylococcus pyogenes, and Haemophilus influenzae, and H. parainfluenzae
Ceftriaxone 2gm IV once daily (first line) OR
Cefotaxime 2gm (50mg/kg) IV three times daily OR
Ampicillin/Sulbactam 3g (50mg/kg) IV q 6 hours OR
Levofloxacin 750mg IV once daily
Consider Vancomycin 15-20mg/kg IV to any of the above if risk of MRSA
Coverage should extend to all of the typical organisms above as well as Pseudomonas, M. tuberculosis, and C. albicans
Cefepime 2g (50/kg) IV q8 hours AND Vancomycin 15mg/kg IV q6 hours
Methylprednisolone 125mg IV vs dexamethasone 0.6mg/kg PO or IM
Controversial
Benefit: anti-inflammatory effect, decreases edema
Many studies, however, have shown no reduction in the need for intubation, the duration of intubation, the duration of intensive care stay, or the duration of hospitalization after corticosteroids. 
Controversial
Benefit: anti-inflammatory effect, decreases edema
Many studies, however, have shown no reduction in the need for intubation, the duration of intubation, the duration of intensive care stay, or the duration of hospitalization after corticosteroids. 
Benefit: anti-inflammatory effect, decreases edema
Many studies, however, have shown no reduction in the need for intubation, the duration of intubation, the duration of intensive care stay, or the duration of hospitalization after corticosteroids. 
First line therapy is awake fiberoptic intubation with patient sitting up.
Preparation should be made for simultaneous cricothyrotomy in case intubation fails
Epiglottitis
Streptococcal pharyngitis 
Peritonsillar cellulitis
Neisseria gonorrhoeae
Nasal foreign body
Diphtheria 
Nasal polyp
Bacterial Tracheitis