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Westley Croup Score

Grades croup severity from level of consciousness, cyanosis, stridor, air entry, and retractions.

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.