What is the Alberta Clinical Practice Guideline scale for croup severity?

Updated: Oct 09, 2019
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Another clinically useful croup severity assessment rating system has been developed by the Alberta Clinical Practice Guideline Working Group. [15, 16]  By following this classification scheme, 21 different general emergency rooms in Alberta, Canada diagnosed 85% of children to have mild croup, and less than 1% with severe croup. The assessment tool used was as follows:

  • Mild severity - Occasional barking cough, no audible stridor at rest, and either no or mild suprasternal and/or intercostal retractions

  • Moderate severity - Frequent barking cough, easily audible stridor at rest, and suprasternal and sternal wall retractions at rest, with no or minimal agitation

  • Severe severity - Frequent barking cough, prominent inspiratory (and occasionally expiratory) stridor, marked sternal wall retractions, significant agitation and distress

  • Impending respiratory failure - Barking cough (often not prominent), audible stridor at rest, sternal wall retractions may not be marked, lethargy or decreased consciousness, and often dusky appearance without supplemental oxygen support

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