While colds, flu and coughs are generally considered easy to diagnose, pharmacy teams should have an understanding of the symptoms that might suggest another condition. These include a noticeably higher breathing rate (above 30 breaths per minute), a significantly raised heart rate (in excess of 130 beats per minute) and anyone who appears to be drifting in and out of consciousness, is complaining of chest pain or whose breathing is so laboured that it is making them feel exhausted. Conditions that can cause similar symptoms to colds and flu but are medical emergencies include meningitis, a blood clot in the lung (pulmonary embolism), trapped air between the lung and chest wall (pneumothorax), and a foreign body lodged in the respiratory tract.

Anyone who appears to be having an asthma or chronic obstructive pulmonary disease (COPD) attack that they are unable to control themselves requires urgent care. There are also some conditions that require a GP's assessment rather than self treatment. These include undiagnosed or uncontrolled asthma or COPD, gastrooesophageal reflux disease, whooping cough (pertussis), glandular fever, malaria, lung cancer, tuberculosis and heart failure. Generally, if something doesn't seem quite right €“ for example, if the patient describes symptoms that do not normally occur during a cold or flu, refer them to the pharmacist.