Acute Stridor Case 2

It is now midnight. All your fellow doctors have gone home for the night. The mother you spoke to earlier has now presented to your department with her 1-year-old baby. You are asked by the nursing staff to come and assess this child urgently.

What are the five components of the Westley Croup score and how do they correspond to severity of the illness?

You walk to the resuscitation room. You find the 1-year-old child at rest with inspiratory stridor, a respiratory rate of 60, tracheal tug, intercostal in-drawing, Sa0₂ of 96% on air with good air entry. She is sitting happily on her mother’s knee.

What is the croup score and how would you describe the severity of this girl with croup?

What are the next steps in your management?

Following a period of observation the child improves dramatically and is running around the room with no distress.

 The mother asks if she can go home now, as she is very tired. What treatment, if any, do you wish to discharge the child with and what advice are you going to give?

See if you can list at least four items in the space below.