Pedemy All toolsAnswer one question at a time. The plan gives doses for the weight entered. Tap any earlier answer to change it.
This croup calculator helps clinicians in the emergency department or clinic grade croup severity and turn that grade into a treatment and disposition plan. Entering the child's weight converts every recommendation into a dose in mg or mL, and any earlier answer can be changed to see how the plan shifts.
The tool first asks whether the picture is typical croup: barky cough, hoarse voice and inspiratory stridor, usually between 6 months and 3 years after a cold. Atypical features such as drooling, a toxic look, high fever, sudden choking onset, age under 6 months or recurrent episodes send you to a list of other causes of stridor, including epiglottitis, bacterial tracheitis and foreign body. Typical croup is then graded as mild, moderate, severe or impending respiratory failure using Westley-based descriptions. For moderate and severe croup it asks how the child looks 2–4 hours after nebulized epinephrine.
Results include dexamethasone 0.6 mg/kg (max 16 mg), with 0.15 mg/kg as an option in mild croup, prednisolone or nebulized budesonide as alternatives, and racemic epinephrine 0.05 mL/kg (max 0.5 mL) or L-epinephrine 0.5 mL/kg (max 5 mL). It also covers home advice, discharge after observation, and admission or PICU criteria. Sources include Bjornson and Johnson (CMAJ 2013), Cochrane reviews (2018 and 2013) and Westley (1978).
The tool uses dexamethasone 0.6 mg/kg once by mouth (or IM), maximum 16 mg. For mild croup, 0.15 mg/kg also works. Prednisolone 1–2 mg/kg is listed if dexamethasone is unavailable, and nebulized budesonide 2 mg if vomiting prevents an oral steroid.
Racemic epinephrine 2.25% is 0.05 mL/kg, maximum 0.5 mL, nebulized in 3 mL saline, and may be repeated every 15–20 minutes. L-epinephrine 1 mg/mL at 0.5 mL/kg, maximum 5 mL, is given as an equivalent alternative.
The tool suggests discharge if there is no stridor at rest 2–4 hours after the last epinephrine dose. Stridor at rest returning, or needing 2 or more doses, points to admission, with PICU if epinephrine is needed more often than every 1–2 hours.
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