Cough

Question 1

Background

Answer 1

Cough is a reflex response from respiratory system to a irritant.
Classes:
Acute - <3 weeks
Sub acute - 3 - 8 weeks
Chronic - >8 weeks

Acute cough usually from URTI.

Question to ask someone with a cough:
Duration?, productive or not?, Sputum colour?, Sudden onset?, other symptoms?, Exacerbating/Alleviating factors?, medications they’re taking?, medical conditions?, environmental irritants?, history of asthma?

Sputum colour can indicate pathology = Table above treatment in pack Y3

Question 2

Referral Signs and Symptoms

Answer 2

Signs and symptoms and why?:
- Duration > 3 weeks = More serious cause the longer the cough has been present.
- Yellow/Green/Brown Sputum = Indication of possible infection requiring antibiotics
- Blood in Sputum (Haemoptysis) = Investigations required to find cause (TB/Rupture etc)
- Persistent nocturnal cough - children = Indication of Asthma
- Ex-smoker, productive chronic cough = Indication of COPD
- Debilitating cough in elderly = Patient group at higher risk of severe symptoms/infections

Question 3

Treatment

Answer 3

Need to recommend course of action could be:
a. Take an appropriate medicinal product.
b. Take an herbal product.
c. Conditional medicinal product recommendation (e.g., ‘If this gets worse you should take this medicine’)
d. Immediate referral for medical help.
e. Conditional referral (e.g., ‘If this doesn’t improve in 7 days you should see your GP’)
f. Non-pharmacological treatment
g. Do nothing
h. Lifestyle change

EXAMPLES
LEMSIP cold & flu, Vicks 1st defence, benylin. Honey/glycerin for <6.

No decongestant to <6 yrs. 6-12 MAX 5 days.

REFER:
<6, P, BF, uncler mucus/phlegm, Blood cough, chest pain SOB wheeze, cough >3 weeks, smoker, High persistent fever, on meds