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Figure 1 is an algorithm for outpatient management of croup based on illness severity. 25 – 34 Keeping a symptomatic child calm by avoiding distressing procedures is important because agitation may worsen airway obstruction. Positioning the child so that he or she is comfortable is appropriate because no particular position has been shown to be more beneficial in the assessment. Oxygen should be administered when the child is hypoxic or in severe respiratory distress. Heliox, a helium-oxygen mixture, has been used to reduce airflow resistance and turbulence. Although case reports have been encouraging, a systematic review found insufficient evidence that heliox is beneficial for croup. 35 Likewise, studies do not support the routine use of exposure to cold air, antipyretics, analgesics, antitussives, decongestants, or prophylactic antibiotics.
The word croup comes from the Early Modern English verb croup , meaning "to cry hoarsely"; the name was first applied to the disease in Scotland and popularized in the 18th century.  Diphtheritic croup has been known since the time of Homer 's Ancient Greece and it was not until 1826 that viral croup was differentiated from croup due to diphtheria by Bretonneau .   Viral croup was then called "faux-croup" by the French and often called "false croup" in English,   as "croup" or "true croup" then most often referred to the disease caused by the diphtheria bacterium .   False croup has also been known as pseudo croup or spasmodic croup.  Croup due to diphtheria has become nearly unknown in affluent countries in modern times due to the advent of effective immunization .