Initial management of croup includes

• A. Intubate immediately.
• B. Position of comfort and avoid agitating.
• C. Administer high-dose steroids immediately.
• D. Use racemic epinephrine only for severe cases.

Answer: (B)

Initial management of croup centers on keeping the child calm and protecting the airway. A position of comfort and minimizing agitation helps prevent worsening of airway edema, since crying and distress can increase subglottic swelling and work of breathing. This supportive, noninvasive approach is the first priority. Steroids to reduce inflammation and medications like racemic epinephrine are used as the illness progresses or based on severity, and intubation is reserved for impending airway failure.