Westley Croup Score
Classifies croup severity to guide management (dexamethasone, nebulised adrenaline, PICU).
Score interpretation
Westley Score 0–2: Mild croup. Barky cough, no stridor at rest.
→ Oral/IM dexamethasone 0.15 mg/kg (max 10 mg). Reassure family. Discharge home if improving.
Westley Score 3–5: Moderate croup. Stridor at rest, mild to moderate retractions.
→ Dexamethasone 0.15 mg/kg. Consider nebulised L-adrenaline (1:1000, 0.5 ml/kg max 5 ml). Monitor 1–2 hours. Admit if no improvement.
Westley Score 6–8: Severe croup. Significant respiratory distress.
→ Senior paediatric review. IV/IM dexamethasone. Nebulised L-adrenaline. High-flow O₂. Consider PICU transfer.
Westley Score ≥9: Impending respiratory failure. Cyanosis or altered consciousness.
→ CALL ANAESTHETIST + PICU NOW. O₂. Nebulised adrenaline. Prepare for emergency intubation. Minimise distress — keep child with parent.
Interpretation bands for the Westley Croup. Apply clinical judgement and local guidance.
References
- Westley CR et al. Nebulized racemic epinephrine by IPPB for the treatment of croup. Am J Dis Child. 1978.
- NICE CG149. Feverish illness in children. 2013.
Related
Curated clinical cross-links plus same-class fallbacks.
- Dexamethasone (Paediatric) · Corticosteroid — Croup / Bacterial Meningitis / Post-Extubation Stridor / Cerebral Oedema
- Dexamethasone · Corticosteroid — ENT Inflammation / Croup
- Adrenaline IM (Paediatric — Anaphylaxis) · Adrenaline (Epinephrine) — Sympathomimetic
- Prednisolone (Paediatric) · Corticosteroid — Asthma Exacerbation / Croup / Nephrotic Syndrome / IBD
- Adrenaline (ICU — Vasopressor/Inotrope) · Catecholamine Vasopressor/Inotrope
- Dexamethasone (ICU / ARDS) · Systemic Corticosteroid
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.