Paediatrics / Respiratory

Westley Croup Score

Severity assessment for acute laryngotracheobronchitis (croup) — guides management from mild (outpatient) to impending respiratory failure (intubation).

0
0/17Mild Croup
0/5 domains answered
Stridor
Chest Wall Retractions
Air Entry
Cyanosis
Level of Consciousness

Westley Croup Score

0/17
0251117
Mild Croup (Score 0/17)
Mild
0–2
Moderate
3–5
Severe
6–11
Resp. Failure
≥12

Management \u2014 Mild Croup

  • 1Single dose oral dexamethasone 0.15–0.6 mg/kg (usual 0.15 mg/kg)
  • 2Discharge with safety-netting advice
  • 3Encourage fluids, comfort measures
  • 4Return if stridor at rest, increased work of breathing, or drooling

Age-Weight Dexamethasone Dosing Reference

AgeEst. Weight0.15 mg/kg0.6 mg/kg
6 months7–8 kg1–1.2 mg4.2–4.8 mg
1 year10 kg1.5 mg6 mg
2 years12 kg1.8 mg7.2 mg
3 years14 kg2.1 mg8.4 mg
4 years16 kg2.4 mg9.6 mg
5 years18 kg2.7 mg10.8 mg

Dexona / Decadron oral solution: 0.5 mg/mL. Injection: 4 mg/mL. Budecort nebulisation: 2 mg as alternative.

Based on Westley CR et al. Am J Dis Child 1978. Enhanced with clinical pearls by Dr Sumit Mandal.