What is the Westley croup score?

The Westley score is a 5-item assessment (0-17 points) that measures croup severity based on stridor, retractions, air entry, cyanosis, and level of consciousness.

What is the PRAM asthma severity score?

PRAM (Preschool Respiratory Assessment Measure) is a 5-item validated assessment (0-12 points) for acute asthma severity in children aged 2-17 years.

When should phototherapy be considered for croup?

For mild croup (Westley ≤2), outpatient management may suffice. Moderate croup (3-5) typically requires corticosteroids; severe croup (≥6) requires systemic steroids and may need hospitalization.

Westley + PRAM

Croup (Westley) & Asthma (PRAM) Severity

Assess respiratory distress in children using two validated scoring systems: Westley croup score and PRAM asthma severity measure.

Westley Croup Score

5-item assessment for laryngotracheitis/croup severity (0–17 points)

Inspiratory Stridor

None (0) When agitated (1) At rest (2)

Retractions

None (0) Mild (1) Moderate (2) Severe (3)

Air Entry

Normal (0) Decreased (1) Markedly decreased (2)

Cyanosis

None (0) With agitation (4) At rest (5)

Level of Consciousness

Normal (0) Disoriented/decreased (5)

Score: —

PRAM (Asthma Severity)

5-item assessment for acute asthma severity in children 2–17 years (0–12 points)

Suprasternal Retractions

Absent (0) Present (2)

Scalene Retractions

Absent (0) Present (2)

Air Entry

Normal (0) Decreased at base (1) Decreased at apex + base (2) Minimal/absent (3)

Wheezing

Absent (0) Expiratory only (1) Inspiratory + expiratory (2) Audible without stethoscope OR silent chest with severe distress (3)

Oxygen Saturation

≥95% (0) 92–94% (1) <92% (2)

Score: —

Assessment Result

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References:

Westley CR, Cotton EK, Brooks JG. Nebulized racemic epinephrine by IPPB for the treatment of croup. Am J Dis Child. 1978;132(5):484-487.
Chalut DS, Ducharme FM, Davis GM. The Preschool Respiratory Assessment Measure (PRAM): a responsive index of acute asthma severity. J Pediatr. 2000;137(6):762-768.

PRAM validated 2–17 years. Westley validated for laryngotracheitis/croup in children.

For clinical decision support only. Not a substitute for clinical judgment. Verify against current guidelines and your institution's protocols.

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