< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray (only if age >40)
Spirometry
Note: Patient will be seen by a Respirologist and Certified Respiratory Educator.
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required
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.
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
CT Chest
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required
Restrictive chest wall disorder (e.g. scoliosis)
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Any history of:- asthma- cancer- COPD- cough duration (must be > 8 weeks)- dyspnea- hemoptysis- interstitial lung disease or pulmonary fibrosis- weight loss >5kg
Chest x-ray
Spirometry
Chronic obstructive pulmonary disease consultation
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray
Spirometry
COPD Education Referrals - No additional information required
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)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required
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)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Lung cavity/Lung cyst
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
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
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Any history of:- asthma- COPD- ischemic heart disease- interstitial lung disease/pulmonary fibrosis- pulmonary embolism
Chest x-ray
Spirometry
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
< 3 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray
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
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
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
IF RESTING 02 SAT < or = 85%: SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
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
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Direct referrals to the Alberta Thoracic Oncology Program
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
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Direct referrals to the Alberta Thoracic Oncology Program
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)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Direct referrals to the Alberta Thoracic Oncology Program
Neoplasm of mesothelial tissue
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Direct referrals to the Alberta Thoracic Oncology Program
Occupational lung disease
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Occupation related symptoms:- cough- wheeze- dyspnea
Spirometry
Osler hemorrhagic telangiectasia syndrome
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Hereditary disease
Positive genetic finding
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Any history of:- cancer (metastatic)- cytology proven malignant effusion- recent (within 2 months) history of pneumonia or empyema
Chest x-ray or CT Chest
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
History of pulmonary embolism
FOR ACUTE PULMONARY EMBOLISM (KNOWN OR SUSPECTED): SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
FOR ACUTE PULMONARY EMBOLISM (KNOWN OR SUSPECTED): SEND THE PATIENT IMMEDIATELY TO AN EMERGENCY DEPARTMENT- DO NOT REFER TO PCAT
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Any history of;- connective tissue disease- cirrhosis- congenital heart disease- HHT
Echocardiogram (showing increased RVSP or other Echo feature suggesting pulmonary hypertension
Suspected or Known
Access to the Pulmonary Hypertension clinic is only through the Pulmonary Central Access Triage service.
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Any history of:- COPD- ILD/Pulmonary fibrosis
Able to walk > 100m in 6 minutes
Able to walk/transfer independently
Diffusion capacity of lung
Spirometry
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Respiratory tract infection
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Synonyms include: Aspiration pneumonia/Aspiration pneumonitis/Bronchitis/Empyema/Pneumonia/Purulent Bronchitis/Recurrent pneumonia/RTI- respiratory tract infection
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
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
Smoking cessation therapy
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
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 "Ast
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Direct referrals to the Alberta Thoracic Oncology Program
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)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Chest x-ray or CT Chest
Hilar/Mediastinal
Thromboembolic pulmonary hypertension
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Any history of;- pulmonary embolism - anti-coagulation status and duration of medication
Echocardiogram
Synonym: Pulmonary Embolism (Chronic)
Tobacco use cessation education
< 15 Days
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required
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)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required
Trachea/Upper Airway:
- obstruction
- fistula
- mass
- stenosis
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Direct referrals to the Tuberculosis Program
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)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required
Medication List (dose, frequency, route)
Summary of relevant medical history
Summary of known or suspected pulmonary condition
No additional information required