• Increased difficulty breathing or worsening of symptoms
• Retractions (tugging in of the skin between, above, or below the ribs with inspiration)
• Lips turn bluish or dusky
• Breathing cool or warm mist does not improve symptoms in 20 minutes
• Inability to drink much over the past 24 hours
• Drooling or difficulty swallowing
• Fever (higher than 103º F [39.4º C])
• Lethargy, listlessness, or severe agitation