Related Experiment Videos
Validation of a croup score and its use in triaging children with croup
S Jacobs1, G Shortland, J Warner
1Intensive Therapy Unit, University Hospital of Wales, Cardiff.
Insights
The Syracuse croup scoring system effectively identifies children needing intensive care for croup. A score over 5 indicates risk, ensuring appropriate triage and monitoring for pediatric patients.
Area of Science:
- Pediatrics
- Critical Care Medicine
Background:
- Croup is a common respiratory illness in children.
- Accurate assessment is crucial for timely intervention.
Purpose of the Study:
- To validate the Syracuse croup scoring system for triage.
- To assess its utility in identifying children requiring intensive therapy.
Main Methods:
- A scoring system was applied to 165 children admitted to an intensive therapy unit.
- The system's performance was evaluated on an additional 134 children.
- Sensitivity and specificity were calculated for a score > 5.
Main Results:
- A score > 5 indicated a high risk of upper airway obstruction, guiding admission decisions.
- The system achieved 100% specificity and 80% sensitivity for identifying children needing intensive care.
- Patients scoring <= 5 were safely managed on general pediatric wards.
Conclusions:
- The Syracuse croup scoring system is a reliable tool for pediatric croup triage.
- It aids in documenting patient progress and informing treatment decisions.
- The system can be recommended for use in pediatric departments.
Abstract:
The Syracuse croup scoring system was validated in 165 children with croup who were admitted to an intensive therapy unit for assessment over a one year period. The unit served as a croup triage point for Cardiff and its environs. A score of > 5 was taken as an indication that a patient was at risk of upper airway obstruction and was used to support a triage decision by the junior hospital doctor to admit a patient to the intensive therapy unit. All patients with an initial score < or = 5 were considered safe for transfer to a general paediatric ward and none of these required subsequent admission to intensive care. This score was then tested on a further 134 children with croup, in order to identify those patients who required specialised monitoring, observation or treatment in intensive care. A score of > 5 gave a specificity of 100% and a sensitivity of 80%. Croup scoring continued after admission on the general paediatric wards. Two patients who were originally admitted to the intensive therapy unit with a score > 5 improved within 6 h and were transferred to the general ward with a score < or = 5. These children subsequently required readmission to the intensive therapy unit. Our tracheal intubation rate of 2% was low and may relate to the routine use of regular adrenaline nebulisation. We recommend this scoring system to other paediatric departments for initial triaging decisions and for documenting progress on the wards.