Absolute indications for referral of the child to the hospital:
(1) cyanosis or severe respiratory distress
(2) marked lethargy or respiratory distress with poor feeding
(3) apneic episodes
(4) fever >= 40°C or toxic appearing infant with diagnostic uncertainty
(5) oxygen saturation < 92% on room air
Relative indications for referral:
(1) congenital heart disease
(2) history of extreme prematurity
(3) pre-existing lung disease
(4) immunodeficiency
(5) Down's syndrome (Trisomy 21, may have pulmonary hypoplasia and/or upper airway obstruction)
(6) social factors that may affect the family's ability to promptly detect or return if clinical status deteriorates
Indications for admission to intensive care:
(1) oxygen saturation <= 92% on oxygen with increasing oxygen requirements
(2) worsening apnea
(3) deterioration in respiratory status with impending exhaustion
