Severe head pain

Persist for 10 days w/ or w/o treatment

Last trimester of pregnancy

<8 yo

High fever or signs of serious infection

Hx liver disease or > or equal to 3 alcoholic drinks/day

Secondary headache (associated with underlying pathology)

Migraine symptoms without formal diagnosis

Patient >6 months old with rectal temp >104 degrees F

Patient <6 months old with rectal temp >101 degrees F

Symptoms of infection

Impaired oxygen utilization (severe COPD, respiratory distress, heart failure)

Impaired immune function (cancer, HIV)

CNS damage

Children with history of seizures or febrile seizures

Persists >3 days

Child with spots/rash, refusal of fluids or can't retain fluids, or sleepy/irritable/hard to wake

Severe pain

Lasts >2 weeks

Lasts >10 days after treatment

Increased intensity or change in character of pain

Pelvic or abdominal pain (other than dysmenorrhea)

Fever, n/v, or other signs of systemic infection

Visually deformed joint, abnormal movement, weakness in any limb, or suspected fracture

Third trimester of pregnancy

< or equal to 7 years old

Fever >101.5 degrees F

Chest pain

SOB

Immunodeficiency

Infants and frail, elderly patients

Children <12 yo

Pregnancy or lactation

Otitis media

Sinusitis

Symptoms of undiagnosed asthma, COPD, or other LRT disorder

Symptoms of allergic rhinitis unresponsive to tx

Sever SE of tx

Green or thick yellow sputum

Fever >101.5 degrees F

Night sweats

Unintended weight loss

Present for >7 days

Hemoptysis (Coughing up blood)

Symptoms of underlying chronic disease (asthma, COPD, CHF, etc.)

Suspected drug-associated cough

Worsens with self-treatment

No previous diagnosis of asthma

Concurrent condition with symptoms similar to asthma

History of severe asthma (requiring steroids or long-term control)

No asthma care provider

Children <5 yo

Pregnancy

Prescription meds seen as ineffective

<12 years old

Pregnany

Severe or frequent infections