Should we admit this patient or not?
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Acute respiratory distress
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YES
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NO
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-Agitation -AMS -Diaphoresis -Retractions -Fragmented speech -Inability to lay supine Trauma
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Attain detailed history
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YES
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NO
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Immediate management
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General exam
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-Past history -Prior intubation -Historical features -Timing -Severity -Chest pain
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-O2 -Determine need for airway -Establish likely cause -IV access -ECG -CXR
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-RR -Pulse ox -Vitals -Breath sounds
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Ancillary tests
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Disposition
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-CXR -ECG -Cardiac enzymes -BNP -D-Dimer -ABG/VBG -CO2 monitoring -Chest CT -V/Q scan -PFT/peak flow
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Improved/stable
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No improvement/Unstable
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Worsening condition or critical condition
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YES
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NO
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YES
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YES
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Home with follow up instructions
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Admit to hospital floor
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Admit to ICU
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