 There will be dedicated research personal in the ED 16 hours a day for the sole purpose of identifying study candidates and ensuring all procedures are followed according to the protocol. This is to ensure continuity through the study process including placement of the consent in the medical record. Since spirometry is an objective test it also allows for shift changes without the need to worry about a different individual measuring the FEV1. Despite this all ED staff physicians, fellows, nurses, technicians will be informed and educated on the purpose, protocol and procedures to be used in the study at regularly scheduled staff meetings. 