Acute cough Flashcards
Differentials for acute cough
URTI
Pneumonia
Exacerbation of COPD
(ACEi)
HPC
SOCRATES Bringing anything up? Any chest pain? Any sore throat? Any trouble swallowing? Fever? (more likely to be pneumonia)
PMH
COPD
Any other PMH
DH
Taking any drugs for high blood pressure?
SH
Any recent travel?
Any contact with animals?
Examinations and investigations
Full set of obs - HR, BP, temp, O2 sats etc
Listen to and percuss the lungs
CRB-65 score for suspected pneumonia:
- Confusion
- Resp rate >30
- BP <90 SBP or <60 DBP
- Age >65
Explaining URTI and Treatment of URTI
Explain that it is likely viral so Abx wont help and have side effects, it should resolve within 7-10 d
- Stop smoking
- Fluids and rest
- Prevent spread - hand hygiene, avoid sharing towels
- Steam inhalation for nasal congestion
- Salt water gargle for sore throat
- Paracetamol/ibuprofen
- Lozenges from the pharmacy
- Nasal decongestant from pharmacy
-Leaflet or website
Treatment of pneumonia
CRB-65 score of 0 or 1:
- Stop smoking
- Rest and fluids
- Paracetamol or ibuprofen for any pain
- Antibiotics e.g. amoxicillin (or dox if they are penicillin allergic)
- If deteriorating come back
Score of 2:
- Above but also consider hospital admission
Score of 3 or 4:
- Urgent hospital admission
LEAFLET
Treatment of exacerbation of COPD
Do spirometry assessment
- Stop smoking
- Exercise
- Get yearly pneumococcal and flu vaccines
- Stress importance of yearly COPD review
- May need to increase short acting inhalers or use steroid inhaler if severe
- Check inhaler technique
- Consider starting Long acting bronchodilator
- Antibiotics (e.g. amox, dox if allergic to penicillin)
SN
If coughing up blood, become SOB or have a high fever come back to the GP
If notice unexpected weight loss come back to the GP
If severely short of breath - go to A&E, dial 999
