BravoCalc

Westley Croup Score Calculator

Westley Croup Score Calculator
Assess the severity of croup in pediatric patients by evaluating five clinical parameters.

Inspiratory Stridor

Chest Wall Retractions

Air Entry

Cyanosis

Level of Consciousness

Total Score: 0 -

Interpretation:

  • Mild: Score ≤ 2
  • Moderate: Score 3-7
  • Severe: Score ≥ 8

Recommendation:

Note:

This calculator is based on the Westley Croup Score. Clinical judgment should always be used alongside this tool. Reassess frequently as croup can progress rapidly.

What is the Westley Croup Score?

The Westley Croup Score is a clinical scoring system used to assess the severity of croup in children. Croup (laryngotracheobronchitis) is a common respiratory condition characterized by a barking cough, inspiratory stridor, hoarseness, and respiratory distress due to inflammation and narrowing of the subglottic region of the larynx.

Clinical Significance

The Westley Croup Score helps clinicians to:

  • Objectively assess the severity of croup
  • Guide treatment decisions
  • Monitor response to therapy
  • Determine the need for hospital admission
  • Predict the risk of respiratory failure

Score Components

The Westley Croup Score evaluates five clinical parameters:

  1. Stridor: The characteristic high-pitched sound heard during inspiration
  2. Retractions: The visible pulling in of the chest wall during breathing
  3. Air entry: The amount of air moving in and out of the lungs
  4. Cyanosis: Bluish discoloration of the skin due to poor oxygenation
  5. Level of consciousness: The child's mental status

Treatment Recommendations

Treatment is based on the severity of croup as determined by the Westley score:

  • Mild (≤2): Supportive care, consider single dose of dexamethasone
  • Moderate (3-7): Dexamethasone, consider nebulized epinephrine, observation
  • Severe (≥8): Dexamethasone, nebulized epinephrine, close monitoring, possible ICU admission

Limitations

The Westley Croup Score has some limitations:

  • Subjective assessment may lead to inter-observer variability
  • May not capture rapid changes in clinical status
  • Not validated for very young infants (less than 3 months)
  • Should not replace clinical judgment

References

  1. Westley CR, Cotton EK, Brooks JG. Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study. Am J Dis Child. 1978;132(5):484-487.
  2. Bjornson CL, Johnson DW. Croup. Lancet. 2008;371(9609):329-339.
  3. Gates A, et al. Glucocorticoids for croup in children. Cochrane Database Syst Rev. 2018;8:CD001955.
  4. Russell KF, et al. Glucocorticoids for croup. Cochrane Database Syst Rev. 2011;(1):CD001955.