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Westley Croup Score

Westley Croup Score
Level of consciousness
Cyanosis
Stridor
Air entry
Retractions
Result0 points

Mild croup.

Severity category
Mild

When to use

  • Grading croup (laryngotracheobronchitis) severity in children to guide treatment (e.g., nebulised epinephrine, corticosteroids) and disposition decisions.

Formula

Sum of five items: level of consciousness (0 or 5), cyanosis (0, 4, or 5), stridor (0-2), air entry (0-2), retractions (0-3). Total range 0-17.

Pearls and pitfalls

  • Commonly categorised as mild (0-2), moderate (3-7), severe (8-11), and impending respiratory failure (≥12), though exact cutoffs vary slightly between studies.
  • Originally developed to standardise assessment of croup severity for a clinical trial of nebulised racemic epinephrine.

References

  1. Westley CR, Cotton EK, Brooks JG. Am J Dis Child. 1978;132(5):484-7.