This pre-referral guideline covers Hoarseness in children of all 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)

Contact information

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