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Upper airway obstruction
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Stridor with severe WOB
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Inability to phonate
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Severe work of breathing
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Severe tachypnea
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Severe retractions
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Gasping
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Grunting
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Bradypnea, apnea
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Oxygen Saturation < 90%
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Artificial airway and/or ventilated patient with respiratory distress
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Cardiopulmonary arrest
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Symptoms of shock
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Severe tachycardia
- Hypotension
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Poor perfusion
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Severe hypertension
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Penetrating trauma to the torso
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Active hemorrhage
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Symptomatic bradycardia
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Acute mental status change
- Extreme agitation
- Combative
- Unresponsive
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Active seizure
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