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This pre-referral guideline covers HoarsenessÌýin children ofÌýall ages.

Initial work-up

• Hoarseness with moderate or severe stridor or respiratory distress should be seen in the Emergency Department.
• History and physical examination - to rule out associated viral or bacterial infection.

Pre-referral treatment

• Treat any associated bacterial infection.
• Observe for viral infections – supportive management.

When to refer

• > 3 months of moderate to severe hoarseness.
• Prolonged voice loss.

Referral form (pdf)

Parent handout (pdf)

Resources

Kids Connect (RCH Primary Care Liaison)

Kids Health Info (Parent fact sheets online)

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References

Paediatric Handbook Ear, Nose and Throat Conditions, Chapter 21 (pp312-324); Robert Berkowitz and Michael Marks; Seventh Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia