TABLE 7.1 HIGH-RISK PATIENTS WITH INCREASED RISK FOR RESPIRATORY, CIRCULATORY, OR NEUROLOGIC FAILURE Respiratory Apparent life-threatening event with history of cyanosis, change in mental status (MS), tone Tracheostomy, ventilator dependence, difficult/critical airway Suspected button battery ingestion Ingestion/foreign body with distress Asthma/bronchiolitis with hypoxemia, altered MS Respiratory distress with hypoxemia/change in MS Circulatory Hematology/oncology patient with fever BMT or solid-organ transplants Sickle cell patient with fever or pain, other patients with asplenia Immune compromised, suppression Petechial, purpuric rash Erythroderma Posttonsillectomy and adenoidectomy with bleeding Infants less than 56 days (8 wks) with fever/hypothermia Bleeding disorder with significant trauma Peritonitis/bilious emesis Cardiac patient with change in baseline pulse oximetry level, change in behavior/MS or perfusion Extremity trauma with neurovascular changes, compartment syndrome Neurologic Not acting right, irritability, stiff neck VP shunt with headache, fever, change in MS, vomiting Diabetic with altered mental status Hypoxic ischemic encephalopathy Frequent or prolonged seizure Focal neurologic symptoms, signs Acute onset of severe HA Suicidal, homicidal ideation, delirium, psychosis