II. Indications

III. Criteria: Protocol 1 (Downes)

  1. Score 4 or above: Moderate airway obstruction
  2. Score 7 or above: Impending respiratory failure
    1. Especially if PaCO2 >45mmHg and paO2 <70 mmHg in room air
  3. Cyanosis
    1. Score 0: None
    2. Score 1: In room air
    3. Score 2: Despite 40% FIO2
  4. Inspiratory breath sounds
    1. Score 0: None
    2. Score 1: Harsh breath sounds with rhonchi
    3. Score 2: Delayed breath sounds
  5. Stridor
    1. Score 0: None
    2. Score 1: Inspiratory Stridor
    3. Score 2: Inspiratory and expiratory Stridor, or Stridor at rest
  6. Cough
    1. Score 0: None
    2. Score 1: Hoarse cry
    3. Score 2: Barky cough
  7. Retractions and nasal flaring
    1. Score 0: None
    2. Score 1: Nasal flaring and suprasternal retractions
    3. Score 2: Subcostal and intercostal retractions (in addition to nasal flaring and suprasternal retractions)
  8. References
    1. Downes (1975) Anesthesiology 43:238-50 [PubMed]

IV. Criteria: Protocol 2

  1. Score >3-4 consistent with moderate croup
  2. Level of Consciousness
    1. Normal: 0
    2. Disoriented: 5
  3. Cyanosis
    1. None: 0
    2. With Agitation: 4
    3. At Rest: 5
  4. Stridor
    1. None: 0
    2. With Agitation: 1
    3. At Rest: 2
  5. Air Entry
    1. Normal: 0
    2. Decreased: 1
    3. Marked: 2
  6. Retractions
    1. None: 0
    2. Mild: 1
    3. Moderate: 2
    4. Severe: 3

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