Syncope
Immunocompromised patients with fever
Hemophilia patients with possible acute bleeds

• Joint pain or swelling.
• History of fall or injury.
• Vital signs and/or mental status outside of baseline.

Febrile infant <28 days of age with fever ≥38.0°C rectal
Hypothermic infants <90 days of age with temperature <36.5°C rectal
Suicidality
Rule out meningitis (headache/stiff neck/fever/lethargy/irritability)
Seizures—prolonged postictal period (altered level of consciousness)
Moderate to severe croup
Lower airway obstruction (moderate to severe)

• Bronchiolitis.
• Reactive airway disease (asthma).
• Respiratory distress:
  • Tachypnea.
  • Tachycardia.
  • Increased effort (nasal flaring, retractions).
  • Abnormal sounds (grunting).
  • Altered mental status.