{
  "card_id": "RESP-DISTRESS-RED-FLAGS-v1",
  "title": "Respiratory distress red flags",
  "applies_to": [
    "all ages",
    "field clinic",
    "disaster response"
  ],
  "required_observations": [
    "respiratory effort",
    "ability to speak",
    "skin or lip color",
    "respiratory rate if available",
    "oxygen saturation if available",
    "mental status"
  ],
  "red_flags": [
    "severe respiratory distress",
    "gasping or unable to speak full sentences",
    "blue lips or cyanosis",
    "marked retractions or tripod positioning",
    "altered mental status with breathing concern",
    "very low oxygen saturation according to local protocol"
  ],
  "escalation_criteria": [
    "Severe breathing difficulty or cyanosis requires emergency escalation.",
    "Altered mental status with respiratory concern requires emergency escalation."
  ],
  "local_actions": [
    "Keep the person under direct observation while escalation is arranged.",
    "Document respiratory effort, color, respiratory rate, oxygen saturation if available, and timeline for handoff."
  ],
  "forbidden_actions": [
    "Do not diagnose the cause of respiratory distress.",
    "Do not provide medication, oxygen-flow, or airway-procedure instructions unless a local clinician or protocol explicitly provides them."
  ],
  "safety_boundary": "Prototype protocol navigation card for trained-responder review only. It is not a clinical guideline and cannot diagnose, prescribe, dose, triage autonomously, or override local protocol.",
  "source_note": "Prototype protocol card derived from public guideline concepts. Not a clinical guideline."
}