Westley Croup Score

Grades severity of croup to guide management

Indication

id: stridor; label: Stridor; type: options; options: label: None; value: 0; label: With agitation only; value: 1; label: At rest; value: 2
id: retractions; label: Retractions; type: options; options: label: None; value: 0; label: Mild; value: 1; label: Moderate; value: 2; label: Severe; value: 3
id: air_entry; label: Air entry; type: options; options: label: Normal; value: 0; label: Decreased; value: 1; label: Markedly decreased; value: 2
id: cyanosis; label: Cyanosis; type: options; options: label: None; value: 0; label: With agitation; value: 4; label: At rest; value: 5
id: consciousness; label: Level of consciousness; type: options; options: label: Normal; value: 0; label: Altered; value: 5

function(score) { if (score <= 2) return { risk: score + '/17', tier: 'Mild Croup', action: 'Dexamethasone 0.6 mg/kg PO (max 16mg) single dose. Discharge with return precautions.', color: 'green' }; if (score <= 7) return { risk: score + '/17', tier: 'Moderate Croup', action: 'Dexamethasone 0.6 mg/kg PO/IM + nebulized racemic epinephrine. Observe 2-4 hours.', color: 'yellow' }; return { risk: score + '/17', tier: 'Severe Croup', action: 'Dexamethasone + racemic epinephrine. Consider ICU admission. Prepare for advanced airway management.', color: 'red' }; }

Dexamethasone 0.6 mg/kg (max 16mg) is the single most effective treatment for all severity levels
Observe at least 2 hours after racemic epinephrine for rebound symptoms
Nebulized budesonide 2mg is an alternative if unable to take oral steroids