Alpha-1 antitrypsin deficiency
Two heartbeats close together followed by a pause
When the apical heart rate and radial pulse are not the same
An abnormally wide pulse pressure
An abnormally large decrease (20+ mmHg) in arterial pressure on inhalation
P. carinii infection
Diffuse ground glass
BUN greater than or equal to 19
Respirations greater than or equal to 30
Heart rate above 110
SBP less than 90 or DBP less than 60
All adults working with immunocompromised populations; yearly
All patients over the age of 10; yearly
All patients over the age of 6 months; yearly
All adults over the age of 65; yearly
All adults over 65 (PCV23), all children under 5 (PCV13)
All adults working in healthcare
All patients over the age of 6 months
All at-risk adults
Patient is not meeting goals of asthma therapy after 3–6 months of treatment.
More than two courses of oral prednisone therapy in the past 12 months.
Any life-threatening asthma exacerbation/exacerbation requiring hospitalization in the past 12 months.
Complicating comorbid problems e.g. rhinosinusitis, tobacco use, multiple environmental allergies, suspected allergic bronchopulmonary mycosis.
Severe or rapidly progressive COPD.
Need for long-term oxygen therapy.
COPD onset occurs before the age of 40.
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