>5VE/min/ Q, ST or T wave abnormalities Raised jugular venous pressure or cardiomegaly 2.21 RESPIRATORY TRACT INFECTION IN LAST 1 MONTH 2.22 CEREBROVASCULAR DISEASE YES NO NO Yes, without hemiplegia Yes, with hemiplegia 2.20 DYSPNOEA 2.23 CURRENT OR RECENT (LAST 5 YR) CANCER DIAGNOSIS NO NO Dyspnoea on exertion or CXR: mild COPD Solid tumour, local only Dyspnoea limiting exertion to <1 flight or CXR: moderate Solid tumour, metastatic disease (including lymph node) COPD Lymphoma Dyspnoea at rest/rate > 30 at rest or CXR: fibrosis or Leukaemia consolidation 2.25 DIABETES MELLITUS 2.27 LIVER DISEASE Not diabetic NO Type 1 Cirrhosis or Hep B/C without portal hypertension Type 2 (on insulin) Cirrhosis or Hep B/C with portal hypertension Type 2 (diet-controlled only) Type 2 (non-insulin glucose-lowering medication) 2.30 SMOKING STATUS 2.31 SMOKING CESSATION REFERRAL Never smoked Ex-smoker > 6 months YES – intensive YES – one off Ex-smoker <6 months Current smoker NO UNKNOWN Unknown 2.32 DAILY ALCOHOL CONSUMPTION 2.35 BOWEL PREP YES NO N/A NONE 0-2 units 3-4 units
>5VE/min/ Q, ST or T wave abnormalities Raised jugular venous pressure or cardiomegaly 2.21 RESPIRATORY TRACT INFECTION IN LAST 1 MONTH YES NO 2.22 CEREBROVASCULAR DISEASE NO Yes, without hemiplegia Yes, with hemiplegia 2.20 DYSPNOEA NO Dyspnoea on exertion or CXR: mild COPD Dyspnoea limiting exertion to <1 flight or CXR: moderate COPD Dyspnoea at rest/rate > 30 at rest or CXR: fibrosis or consolidation 2.23 CURRENT OR RECENT (LAST 5 YR) CANCER DIAGNOSIS NO Solid tumour, local only Solid tumour, metastatic disease (including lymph node) Lymphoma Leukaemia 2.25 DIABETES MELLITUS Not diabetic Type 1 Type 2 (on insulin) Type 2 (diet-controlled only) Type 2 (non-insulin glucose-lowering medication) 2.27 LIVER DISEASE NO Cirrhosis or Hep B/C without portal hypertension Cirrhosis or Hep B/C with portal hypertension 2.30 SMOKING STATUS Never smoked Ex-smoker > 6 months Ex-smoker <6 months Current smoker Unknown 2.31 SMOKING CESSATION REFERRAL YES – intensive YES – one off NO UNKNOWN 2.32 DAILY ALCOHOL CONSUMPTION NONE 0-2 units 3-4 units 2.35 BOWEL PREP YES NO N/A
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