Children with laryngotracheobronchitis, usually a more severe type of croup, are more often hospitalized than are those with acute spasmodic croup. Racemic epinephrine nebulized with oxygen may be given to decrease the laryngeal edema and bronchospasm. The child must be observed closely for changes in respiratory status and should not be treated with epinephrine on an outpatient basis because the effects of epinephrine are temporary. Rebound stridor may occur. Children who receive epinephrine should be observed in the emergency department for at least 3 hours after treatment and should not be discharged if stridor or retractions are present.