Westley croup severity score (appropriate for use in children ≤6 years of age)

 

Level of consciousness
		Normal, including sleep (0 points)
		Disoriented (5 points)
Cyanosis
		None (0 points)
		With agitation (4 points)
		At rest (5 points)
Stridor
		None (0 points)
		With agitation (1 point)
		At rest (2 points)
Air entry
		Normal (0 points)
		Decreased (1 point)
		Markedly decreased (2 points)
Retractions
		None (0 points)
		Mild (1 point)
		Moderate (2 points)
		Severe (3 points)

 
Important: Inputs must be complete to perform calculation.

 

Total Criteria Point Count:
 

 

Westley croup severity score interpretation

 

Score	Severity	Description
0 to 2	Mild	Occasional barky cough, no stridor at rest, mild or no retractions
3 to 7	Moderate	Frequent barky cough, stridor at rest, and mild-to-moderate retractions, but no or little distress or agitation
8 to 11	Severe	Frequent barky cough, stridor at rest, marked retractions, significant distress and agitation
12 to 17	Impending respiratory failure	Depressed level of consciousness, stridor at rest, severe retractions, poor air entry, cyanosis or pallor

 

 

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 May;132(5):484-7. PubMed ID: 347921