Pulmonology Book

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Croup Score

Aka: Croup Score, Clinical Croup Score, Westley Croup Score, Downes Croup Score
  1. See Also
    1. Croup
  2. Indications
    1. Laryngotracheal Bronchitis (Croup) Evaluation
  3. Criteria: Protocol 1 (Westley)
    1. Interpretation
      1. Score <= 2 Mild croup
      2. Score 3 - 7 Moderate croup
      3. Score 8 - 11 Severe croup
      4. Score >=12 Impending Respiratory Failure
    2. Level of Consciousness
      1. Normal: 0
      2. Disoriented: 5
    3. Cyanosis
      1. None: 0
      2. With Agitation: 4
      3. At Rest: 5
    4. Stridor
      1. None: 0
      2. With Agitation: 1
      3. At Rest: 2
    5. Air Entry
      1. Normal: 0
      2. Decreased: 1
      3. Marked: 2
    6. Retractions
      1. None: 0
      2. Mild: 1
      3. Moderate: 2
      4. Severe: 3
    7. References
      1. Westley (1978) Am J Dis Child 132(5): 484-7 [PubMed]
  4. Criteria: Protocol 2 (Downes)
    1. Interpretation
      1. Score 4 or above: Moderate airway obstruction
      2. Score 7 or above: Impending Respiratory Failure
        1. Especially if PaCO2 >45mmHg and paO2 <70 mmHg in room air
    2. Cyanosis
      1. Score 0: None
      2. Score 1: In room air
      3. Score 2: Despite 40% FIO2
    3. Inspiratory breath sounds
      1. Score 0: None
      2. Score 1: Harsh breath sounds with rhonchi
      3. Score 2: Delayed breath sounds
    4. Stridor
      1. Score 0: None
      2. Score 1: Inspiratory Stridor
      3. Score 2: Inspiratory and expiratory Stridor, or Stridor at rest
    5. Cough
      1. Score 0: None
      2. Score 1: Hoarse cry
      3. Score 2: Barky cough
    6. Retractions and nasal flaring
      1. Score 0: None
      2. Score 1: Nasal flaring and suprasternal retractions
      3. Score 2: Subcostal and intercostal retractions (in addition to nasal flaring and suprasternal retractions)
    7. References
      1. Downes (1975) Anesthesiology 43:238-50 [PubMed]

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