Westley Croup Score
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- Definitions of croup severity are neither widely accepted nor rigorously derived.
- A more clinically relevant classification scheme was developed by the Alberta Medical Association Clinical Practice Guideline Working Group.
- Severity classifications are correlated with Westley Croup Scores.
- Treatment algorithms differ among institutions.
- A 2012 Cochrane review showed that glucocorticoids improved the Westley Croup Score at 6 and 12 hours, prevented repeat visits, and decreased length of stay (Russell 2011).
- The optimal dose of glucocorticoid has not yet been determined, though conventionally, the dose used is 0.6mg/kg of dexamethasone, administered IV or orally (Russell 2011).
- A small study in Thailand compared 0.15mg/kg to 0.6mg/kg and found no difference in Westley Croup Score, though this was a small study (n = 41) and patients also received racemic epinephrine nebulization prior to steroid administration (Chubb-Uppakarn 2007).
The Westley Croup Score was designed to track changes in the presentation of croup over time, and is primarily used in research studies. Croup remains a clinical diagnosis, with the hallmark symptoms of barky cough, hoarse voice, with or without stridor.
- Joshua Beiner, MD
- Matthew Lecuyer, MD