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Home/Clinical calculators/Westley Croup Score

Clinical calculator · Pediatrics and neonatology

Westley Croup Score

Grades croup severity to guide corticosteroid and epinephrine treatment decisions

Highest activation tier
Mandatory
How it is scored
Scored in code; a stated value is compared only from the structured summary or a supplied value
Scoring type
point sum
Care settings
Emergency department, Inpatient

When it activates

Scribeable activates a calculator from the encounter. The Westley Croup Score can activate when the transcript or pasted chart context documents any of these:

  • Croup severity assessment
  • Laryngotracheobronchitis grading
  • Pediatric stridor evaluation

A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: J05.

Inputs the note needs

1 input. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.

InputTypeUnit / optionsGuidance
Westley Croup Score total (0-17)exam

Reference for licensed clinicians. Where the registry text carries dose thresholds or conversion factors, they are as published in the cited sources. This page is not a prescribing tool and not individualised medical advice; verify against a current drug reference and the current guideline before acting. Medical disclaimer.

Scoring

Stridor (0-2), retractions (0-3), air entry (0-2), cyanosis (0-5), level of consciousness (0-5). Total 0-17.

Interpretation

≤2: Mild croup — dexamethasone. 3-5: Moderate — dexamethasone, consider racemic epinephrine. 6-11: Severe — racemic epinephrine + dexamethasone, close monitoring. ≥12: Impending respiratory failure — emergent airway management.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Westley 1978.

  • Westley CR et al. Nebulized racemic epinephrine by IPPB for the treatment of croup (Westley Croup Score)Westley et al. (Croup Score) 1978 · 1978 · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Westley Croup Score at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.

The score is computed in code from the resolved inputs, not recalled by the language model. A stated Westley Croup Score value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

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Can activate in: Emergency Medicine, Pediatrics.

Scored in code

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