Croup Epinephrine Rebound ========================= þ The older literature suggested that there is a problem with "rebound" after giving epinephrine aerosols, but more recent studies don't bear this out; indeed, they seem to show that discharge after epinephrine (plus observation, generally 2-4 hours) is safe, provided the patient is also treated with steroids. [Kelley PB Simon JE. Racemic epinephrine use in croup and disposition. Am J Emerg Med 1992(May);10(3):181-3.] Abstract: [Prendergast M, Jones JS, Hartman D. Racemic epinephrine in the treatment of laryngotracheitis: can we identify children for outpatient therapy? Am J Emerg Med 1994(Nov);12(6):613-6.] Abstract: [Ledwith CA, Shea LM, Mauro RD. Safety and efficacy of nebulized racemic epinephrine in conjunction with oral dexamethasone and mist in the outpatient treatment of croup. Ann Emerg Med 1995(Mar);25(3):331-7.] Abstract: [Kunkel NC, Baker MD. Use of racemic epinephrine, dexamethasone, and mist in the outpatient management of croup. Pediatr Emerg Care 1996;12(3):156-159.]