Self Care 2025: Exclusion Criteria for all topics

Exclusion Criteria for a Cold

-Fever >100.4 F

-Chest Pain, SOB

-Worsening of symptoms or development of additional symptoms during self-treatment

-Concurrent underlying chronic cardiopulmonary diseases (asthma, COPD, CHF)

-AIDS or chronic immunosuppressant therapy

-Frail patients of advanced age

-Infants < 3 months old

-Hypersensitivity to recommended OTC meds

Exclusion Criteria for Cough

-Difficulty breathing, shortness of breath, dyspnea

-Cyanosis, hemoptysis

-Weight loss

-Night sweats

-Cough that worsens after 3-5 days

-Cough that does not subside after 2-3 weeks

-Children under 4 years old

-Temp over 100.4, temp over 100 for over 3 days

-Barking cough (croup), whooping cough

-Cough that begins suddenly without fever

-Immunocompromised, risk factors for HIV, chronic illness

Exclusion Criteria for Headache

-Severe head pain

-Headache with rapid onset of maximum pain

-Concerning change in headache pattern (first or worst headache; gradual escalation over months)

-Headache that persists for 10 days, with or without treatment

-Age <8yrs

-High fever or signs of serious infection

-Neck stiffness

-Neurologic change (visual disturbances, seizure, mental status change)

-High-risk comorbid conditions (cancer, HIV)

-Last trimester of pregnancy

-New headache during pregnancy

-Headache associated with underlying pathology (secondary headache), except for minor sinus headaches

-Symptoms consistent with migraine, but no formal diagnosis of migraine headache

-History of liver disease or consumption of 3+ alcoholic drinks per day

Exclusion Criteria for Fever

-Patients >3 months of age with rectal temp >104.0F or equivalent

-Patients <3 months of age with rectal temp >100.4F

-Children <2yrs of age with fever that persist for >24hrs

-Patients >2yrs with fevers that persist >3 days with or without treatment

-Fever that repeatedly rises above 104.0F in children of any age

-Risk for hyperthermia

-Impaired oxygen utilization (CV, pulmonary disease)

-Impaired immune function (cancer, HIV)

-CNS damage (head trauma, stroke)

-Severe symptoms of infection that are not self-limiting

-Children with: History of febrile seizures or seizures; Stiff neck; Develops rash/spots; Refuses to drink any fluids; Irritable, very sleepy, or hard to wake up; Vomiting and cannot keep fluids down; Repeated diarrhea.

Exclusion Criteria for Eye Surface Disorders

-Eye pain

-Blurred vision not associated with ophthalmic ointments

-Sensitivity to light

-History of contact lens wear

-Blunt trauma to the eye

-Chemical exposure affecting eye

-Eye exposure to heat excluding sun exposure

-Symptoms that have persisted for > 72 hours

Exclusion Criteria for Allergic Conjunctivitis

-S/s of infection of eyelids (red, thickened lids, scaling)

-Blunt trauma to eye

-Exposure of eye to chemical

-Head lice

-Macular degeneration

-Hordeolum, chalazion, blepharitis

Exclusion Criteria for Impacted Cerumen

-Signs of infection (irritation, rash)

-Pain associated with ear discharge

-Bleeding or signs of trauma

-Ruptured tympanic membrane

-Ear surgery in past 6 weeks

-Tympanostomy tubes present

-Incapable of following proper instructions

-Hypersensitivity to available OTC agents

-<12 years old

-Condition worsening after attempted self-treatment

Exclusion Criteria for Water Clogged Ears

-Signs of infection (irritation, rash)

-Pain associated with ear discharge

-Dizziness

-Bleeding or signs of trauma

-Presence of ruptured tympanic membrane

-Ear surgery in past 6 weeks

-Tympanostomy tubes present

-Incapable of following proper instructions

-Hypersensitivity to available OTC agents

-Condition worsening after attempted self-treatment

Exclusion Criteria for Musculoskeletal Pain

-Sever pain (>6)

-Pain that last >10 days

-Pain that continues >7 days after starting topical analgesic

-Increase/Change in intensity or character of pain

-Pelvic or abdominal pain (except dysmenorrhea)

-Accompanying N/V, fever, or other signs of systemic infection/disorder

-Visually deformed joint, abnormal movement, weakness in any limb, numbness or suspected fracture

-Pregnancy

-<2 yo

-Back pain and loss of bowel/bladder control

Exclusion Criteria for Insomnia

-<12 yrs old

-65+ yrs old

-Pregnant or breastfeeding

-Frequent nocturnal awakenings or early morning awakenings

-Chronic insomnia (3+ months)

-Sleep disorder secondary to psychiatric or general medical disorders

Exclusion Criteria for Drowsiness and Fatigue

-<12 yrs old

-Pregnancy or breastfeeding

-Cardiac conditions

-Anxiety disorders

-Medication-induced drowsiness

-Chronic fatigue defined as 6+ months of fatigue

Exclusion Criteria for Vulvovaginal Candidiasis

-Pregnancy

-Girls <12 yrs of age

-Concurrent symptoms: fever or pain in the pelvic area, lower abdomen, back, or shoulder

-Medications that increase risk of VVC (corticosteroids, antineoplastics)

-Medical disorders that can predispose to VVC (diabetes, HIV infection)

-Recurrent VVC (>3 infections/year, or 2 infections in past 2 months)

-First vulvovaginal episode

Exclusion Criteria for Atopic Dermatitis

-Moderate to severe condition with intense pruritis

-Involvement of large area of the body

-<1 y/o

-Skin appears infected (yellow crusty)

-Involvement of face or intertriginous areas (where two skin areas may touch or rub together)

Exclusion Criteria for Allergic Contact Dermatitis

-<2 y/o

-Dermatitis >2 weeks

-Involvement of >20% of BSA

-Presence of numerous bullae

-Extreme itching, irritation, or severe vesicle or bullae formation

-Swelling of the body or extremities

-Swollen eyes or eyelids swollen shut

-Discomfort in genitals from itching, redness, swelling or irritation

-Involvement and/or itching of mucous membranes of mouth, eyes, nose, or anus

-Signs of infection

-Failure of self-management after 7 days

-Low tolerance for pain, itching, or symptom discomfort

-Impairment of daily activities

Exclusion Criteria for Diaper Dermatitis

-Lesions >7 days

-Lesions after 7 days of appropriate care

-Secondary infection

-Lesions caused by another disease state

-Dermatitis outside of diaper region

-Possibly associated with UTI

-Presence of broken skin

-Onion-skin like presentation or presence of bullae

-Oozing or blood or pus present

-Chronic or frequently occurring lesions

-Presence of constitutional symptoms

-Significant behavioral changes

-Comorbid conditions

Exclusion Criteria for Insect Stings

-Hives, excessive swelling, dizziness, weakness, nausea, vomiting, difficulty breathing

-Significant allergic response away from the sting

-Previous sting by bee, wasp, or hornet (need to evaluate possible development of hypersensitivity)

-Previous severe reaction to insect bite

-Personal or family history of significant allergic reaction

-<2 years of age

Exclusion Criteria for Bug Bites

-Hypersensitivity to insect bites, resulting in systemic symptoms or symptoms away from bite area

-<2 years of age

-History of tick bite and systemic effects indicating possible infection

-Suspected spider bite requiring medical attention

-Signs of secondary infection of bite area

Exclusion Criteria for Pediculosis

-Hypersensitivity to chrysanthemums, ragweed, or pediculicide ingredients

-Presence of secondary skin infection in lice-infested area

-<2 years old for pyrethrins

-<2 months old permethrins

-Lice infestation of eyelids or eyebrows

-Pregnancy or breastfeeding/chestfeeding (strong caution for self-treatment; benefits must outweigh risks)

-Presence of active tumors

-Regional resistance to pediculicides

Exclusion Criteria for Acne

-Moderate to severe acne

-Exacerbating factors (comedogenic drugs, mechanical irritation)

-Possible rosacea

Exclusion Criteria for Sun Exposure

-Allergy to all sun protectant ingredients

-<6 months of age

Exclusion Criteria for Burns

-Burn to BSA of 2% or more

-Burns involving eyes, ears, face, hands, feet, or perineum

-Chemical burns (use first-aid measures then seek medical attention)

-Electrical or inhalation burns

-Persons of advanced age

-Patients with diabetes or multiple medical disorders

-Immunocompromised patients

Exclusion Criteria for Heartburn

-Frequent heartburn >3 mo

-Heartburn while taking rec dosage of nonprescrip H2RA/PPI

-Heartburn that continues after 2 weeks of treat w nonprescrip H2RA/PPI

-Heartburn and dyspepsia that occur when taking prescrip H2RA/PPI

-Severe heartburn and dyspepsia

-Nocturnal heartburn

-Difficulty/pain on swallowing solid foods

-Vomiting blood/black material or passing black tarry stools

-Chronic hoarseness, wheezing, coughing, choking

-Unexplained weight loss

-Continuous N/V/D

-Chest pain accompanied by sweating, pain radiating to shoulder, arm, neck, or jaw, and SOB

-Children <2 yrs (antacids), 12 yrs (H2RAs), 18 yrs (PPIs)

-Adults > 45 yrs w new-onset dyspepsia

Exclusion Criteria for Intestinal Gas

-Intestinal gas symptoms that persist for more than several days or occur more often than occasionally (e.g., several times a month)

-Severe debilitating symptoms

-Sudden change in the location of abdominal pain, significant increase in frequency or severity of symptoms, or onset of symptoms in patients 40 years of age

-Symptoms accompanied by significant abdominal discomfort or a sudden change in bowel function (either diarrhea or constipation)

-Presence of accompanying signs and symptoms such as severe or persistent diarrhea or constipation, GI bleeding, fatigue, unintentional weight loss, or frequent nocturnal symptoms

Exclusion Criteria for Constipation

-Marked abdominal pain or significant distention or cramping

-Marked or unexplained flatulence

-Fever

-N/V

-Present of a chronic medication condition that may preclude self-care laxative treatment (paraplegia or quadriplegia, inflammatory bowel disease, colostomy)

-Unexplained changes in bowel habits, especially if accompanied by weight loss

-Blood in still or dark, tarry stool

-Marked change in character of stool (e.g., stool becomes pencil thin)

-Any bowel symptoms that persist >2 weeks or recur over a period of at least 3 months

-Any bowel symptoms that recur after dietary or lifestyles changes, or laxative use

-Inflammatory bowel disease

-Anorexia

-Age <2 yrs

Exclusion Criteria for Hemorrhoids

-Children <12 years

-GI disease or FH colon cancer

-Seepage, bleeding, thrombosis

-Severe itching, burning, pain

-Fever

-Symptoms persisting > 7 days

Exclusion Criteria for Nausea/Vomiting

-Urine ketones and/or high BG with signs of dehydration in patients with diabetes

-Suspected food poisoning that does not clear up after 24 hours

-Severe abdominal pain in the middle or RLQ

-N/V with fever and/or diarrhea

-Severe RUQ pain, esp after eating fatty foods

-Blood in the vomitus

-Yellow skin or eye discoloration

-Stiff neck with or without headache and sensitivity to brightness of normal light

-Head injury with N/V, blurry vision, or numbness and tingling

-Persons with glaucoma, BPH, chronic bronchitis, emphysema, or asthma (may react adversely to OTC antiemetics)

-Pregnancy (severe symptoms) or breastfeeding

-N/V caused by cancer chemotherapy; radiation therapy; serious metabolic disorders; CNS, GI, or endocrine disorders

-Drug-induced N/V: adverse effects of drugs used therapeutically (opioids, NSAIDs, antibiotics, estrogens); toxic doses of drugs used therapeutically (digoxin, theophylline, lithium); ethanol

-Psychogenic-induced N/V: bulimia, anorexia

-Chronic disease-induced N/V: gastroparesis with diabetes, DKA or HHS with diabetes, GERD

Exclusion Criteria for Diarrhea

-Young age (<6 months or weight <17.5 lbs)

-Persistent fever (+100.4 F for patients <3 months; +102.2 for patients 3+ months)

-Visible blood, pus, or mucus in stool

-High output, including frequent and substantial volumes of diarrhea

-Persistent vomiting

-Signs of severe dehydration

*Children showing behavioral/mental changes (irritability, apathy, lethargy, unconscious)

*Children who have not urinated in 8 hours

*Children who have no tears when crying

*Orthostatic hypotension

-Severe abdominal pain/distress: tenderness, distention

-Risk for significant conplications, including chronic medical conditions or concurrent illness

*Diabetes, severe CVD, renal disease

*Immunosuppressed patients (e.g. from cancer chemotherapy, organ transplantation, AIDS), frail patients 65+ yrs

-Pregnancy

-Chronic or persistent diarrhea

-Suboptimal response to ORS already administered