Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray (only if age >40)
| Within 12 months
Spirometry
| Within 12 months
Note: Patient will be seen by a Respirologist and Certified Respiratory Educator.
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
No additional information required
Note: Patient will be assessed by a Certified Respiratory Educator, but will not be reviewed by a Respirologist. This assessment may include spirometry- as the referring physician you will also be deemed the responsible physician for spirometry results. If you would like the patient to be seen in consult by a Respirologist, please select "Asthma Management" as the reason for referral.
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
CT Chest
| Within 12 months
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
Restrictive chest wall disorder (e.g. scoliosis)
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Any history of:- asthma- cancer- COPD- cough duration (must be > 8 weeks)- dyspnea- hemoptysis- interstitial lung disease or pulmonary fibrosis- weight loss >5kg
| As relevant
Chest x-ray
| Within 6 months
Spirometry
| Within 6 months
Chronic obstructive pulmonary disease consultation
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray
| Within 12 months
Spirometry
| Within 12 months
COPD Education Referrals - No additional information required
| N/A
Note- for COPD Consult referrals: Patient will be seen by a Respirologist and Certified Respiratory Educator.
Note- for COPD Education referrals: Patient will be assessed by a Certified Respiratory Educator, but will not be reviewed by a Respirologist. This assessment may include spirometry- as the referring physician you will also be deemed the responsible physician for spirometry results.
Combined disorder of muscle AND peripheral nerve
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
Neuromuscular Related Respiratory Disorder
Synonyms include: Combined disorder of muscle AND peripheral nerve/Diaphragm paralysis/Myoneural disorders/Myotonic dystrophy/Scoliosis
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 1 month
Lung cavity/Lung cyst
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 6 months
Pleural Disease or Disorder
Synonyms include: Chylothorax/Empyema/Fibrothorax/Hemothorax/Mesothelioma/Para-pneumonic effusion/Pleural cuirasses/Pleural fibrosis/Pleural metastases/Pleural plaque/Pleural scarring/Pleural thickening/Pleuritis/Pneumothorax/Rounded atelectasis
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Any history of:- asthma- COPD- ischemic heart disease- interstitial lung disease/pulmonary fibrosis- pulmonary embolism
| As relevant
Chest x-ray
| Within 6 months
Spirometry
| Within 6 months
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 12 months
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray
| Within 1 month
Duration and amount of blood (TBSPs or mLs per day)
| As relevant (see Additional Details)
If Active and > or = 2 TBSPs (30cc) per day: SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
| N/A
If Active and > or = 2 TBSPs (30cc) per day: SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
If Active and less than 2 TBSPs (30cc) per day OR there is past history of hemoptysis but not active/intermittent: REFER TO PCAT
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
IF RESTING 02 SAT < or = 85%: SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
| As relevant
IF RESTING 02 SAT < or = 85%: SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
IF RESTING 02 SAT > 85%: REFER TO PCAT
Interstitial lung disease
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 12 months
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 12 months
Direct referrals to the Alberta Thoracic Oncology Program
| N/A
Lung nodule(s)/Lung mass(es)
REFER DIRECTLY TO THE CALGARY ZONE ALBERTA THORACIC ONCOLOGY PROGRAM (ATOP), FOOTHILLS MEDICAL CENTRE (Phone: 403-944-1774; Fax: 403-944-8848)
Lung transplant assessment
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 12 months
Direct referrals to the Alberta Thoracic Oncology Program
| N/A
Primary or Metastatic
REFER DIRECTLY TO THE CALGARY ZONE ALBERTA THORACIC ONCOLOGY PROGRAM (ATOP), FOOTHILLS MEDICAL CENTRE (Phone: 403-944-1774; Fax: 403-944-8848)
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Direct referrals to the Alberta Thoracic Oncology Program
| N/A
Neoplasm of mesothelial tissue
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Direct referrals to the Alberta Thoracic Oncology Program
| N/A
Occupational lung disease
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 6 months
Occupation related symptoms:- cough- wheeze- dyspnea
| As relevant
Spirometry
| Within 6 months
Osler hemorrhagic telangiectasia syndrome
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Hereditary disease
| N/A
Positive genetic finding
| N/A
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Any history of:- cancer (metastatic)- cytology proven malignant effusion- recent (within 2 months) history of pneumonia or empyema
| As relevant
Chest x-ray or CT Chest
| Within 1 month
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
History of pulmonary embolism
| As relevant
FOR ACUTE PULMONARY EMBOLISM (KNOWN OR SUSPECTED): SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
| N/A
FOR ACUTE PULMONARY EMBOLISM (KNOWN OR SUSPECTED): SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Any history of;- connective tissue disease- cirrhosis- congenital heart disease- HHT
| As relevant
Echocardiogram (showing increased RVSP or other Echo feature suggesting pulmonary hypertension
| Within 6 months
Suspected or Known
Access to the Pulmonary Hypertension clinic is only through the Pulmonary Central Access Triage service.
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Any history of:- COPD- ILD/Pulmonary fibrosis
| As relevant
Able to walk > 100m in 6 minutes
| As relevant
Able to walk/transfer independently
| As relevant
Diffusion capacity of lung
| Within 6 months
Spirometry
| Within 6 months
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 3 months
Respiratory tract infection
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 6 months
Synonyms include: Aspiration pneumonia/Aspiration pneumonitis/Bronchitis/Empyema/Pneumonia/Purulent Bronchitis/Recurrent pneumonia/RTI- respiratory tract infection
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Direct referrals to the Foothills Medical Centre Sleep ClinicFor pediatric patients with Sleep Apnea please direct referrals to the Alberta Children's Hospital Pediatric Sleep Clinic
| N/A
Smoking cessation therapy
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
Note: Patient will be assessed by a Certified Respiratory Educator, but will not be reviewed by a Respirologist. This assessment may include spirometry- as the referring physician you will also be deemed the responsible physician for spirometry results. If you would like the patient to be seen in consult by a Respirologist, please select "Ast
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 12 months
Direct referrals to the Alberta Thoracic Oncology Program
| N/A
Primary or Metastatic
REFER DIRECTLY TO THE CALGARY ZONE ALBERTA THORACIC ONCOLOGY PROGRAM (ATOP), FOOTHILLS MEDICAL CENTRE (Phone: 403-944-1774; Fax: 403-944-8848)
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Chest x-ray or CT Chest
| Within 6 months
Hilar/Mediastinal
Thromboembolic pulmonary hypertension
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Any history of;- pulmonary embolism - anti-coagulation status and duration of medication
| As relevant
Echocardiogram
| Within 12 months
Synonym: Pulmonary Embolism (Chronic)
Tobacco use cessation education
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
No additional information required
Note: Patient will be assessed by a Certified Respiratory Educator, but will not be reviewed by a Respirologist. This assessment may include spirometry- as the referring physician you will also be deemed the responsible physician for spirometry results. If you would like the patient to be seen in consult by a Respirologist, please select "Asthma Management" as the reason for referral.
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
Trachea/Upper Airway:
- obstruction
- fistula
- mass
- stenosis
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Direct referrals to the Tuberculosis Program
| N/A
FOR KNOWN OR SUSPECTED ACTIVE TB: Call the Calgary TB Clinic immediately (403-944-7660) during normal business hours (M-F: 8:00am- 4:30pm) OR call RAAPID (South: 1-800-661-1700) and ask for the TB doctor on-call. REFER DIRECTLY TO CALGARY TUBERCULOSIS SERVICES (Phone: 403-944-7660; Fax: 403-291-9185)
Upper respiratory tract finding
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A
Medication List (dose, frequency, route)
| Within 1 month
Summary of relevant medical history
| Within 1 month
Summary of known or suspected pulmonary condition
| Within 1 month
No additional information required
| N/A