Those with severe dyspnea, significantly decreased level of consciousness, persistent or worsening hypoxemia and/or severe or worsening respiratory acidosis (e.g., pH less than 7.25) despite supplemental oxygen and NIV, respiratory failure requiring intubation, or hemodynamic instability requiring vasoactive medications should be admitted to an intensive care unit for further careful management.⁴

Dr. Glauser is professor of emergency medicine at Case Western Reserve University at MetroHealth Cleveland Clinic in Cleveland.

Dr. O’Hora is an emergency medicine physician in Cleveland Heights, Ohio.

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