VALIDATION OF A CROUP SCORE AND ITS USE IN TRIAGING CHILDREN WITH CROUP

The Syracuse croup scoring system was validated in 165 children with c roup who were admitted do an intensive therapy unit for assessment ove r a one year period. The unit served as a croup triage point for Cardi ff 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 fo suppor t a triage decision by the junior hospital doctor to admit a patient f o the intensive therapy unit. All patients with an initial score less than or equal to 5 were considered safe for transfer to a general paed iatric ward and none of these required subsequent admission to intensi ve care. This score was then tested on a further 134 children with cro up, in order to identify those patients who required specialised monit oring, observation or treatment in intensive care. A score of > 5 gave a specificity of 100% and a sensitivity of 80%. Croup scoring continu ed after admission on the general paediatric wards. Two patients who w ere originally admitted to the intensive therapy unit with a score > 5 improved within 6 h and were transferred fa the general ward with a s core less than or equal to 5. These children subsequently required rea dmission to the intensive therapy unit. Our tracheal intubation rare o f 2% was low and may relate to the routine use of regular adrenaline n ebulisation. We recommend this scoring system to other paediatric depa rtments for initial triaging decisions and for documenting progress on the wards.