GP - Common cold (with info on NSAIDs) Flashcards
What is common cold?
A mild, self-limiting, viral URTI characterised by nasal congestion and discharge, sneezing, sore thorat, and cough
What is the most common cause of a common cold?
Rhinovirus
How is a common cold transmitted?
- Direct contact
- Aerosols
(People with a cold can remain infectious (shedding the virus) for weeks)
Which age agroup does a common cold most commonly affect?
Affects all age, however, it’s most common in children
Why are children more susceptible to cold?
Fewer antibodies, so good reservoirs of infection
Tend to have a higher viral load in secretions, and they shed viruses for longer i.e. remain infectious for longer
Close contact with ther children and adults
Give 3 complications of a common cold
- Acute sinusitis
- Acute otitis media
- Lower respiratory tract infections e.g. bronchitis, acute exacerbation of asthma or COPD, pneumonia
Give 3 risk factors for developing a common cold
- Co-morbidities e.g. asthma, COPD
- Elderly patients and children who were born prematurely
- Immunocompromise
- Smoking
How long does a common cold usually last?
Symptoms usually last around 1 week in adults and older children, although they may last longer, in particular, cough can last up to 3 weeks
Symptoms usually last 10-14 days in younger children
What are the clinical features of a common cold in an adult or older child?
Onset of symptoms is usually over 1-2 days
- Sore throat (often the 1st symptom)
- Nasal congestion, nasal discharge (often clear), sneezing
- Cough
- Hoarse voice caused by associated larygnitis
- Other less common symptoms include:
- Fever, headache, myalgia, loss of taste and smell, pressure in ears or sinuses
What examinations/ bedside tests would a GP do in a patient with common cold?
Chest auscultation
Throat examination e.g. pharygnitis, tonsillitis
Check temperature
What are the differential diagnoses for a common cold?
- Meningitis - fever, headache, neck stiffness, photophobia in adults; fever, drowsiness, staring expression, vomiting, high-pitched crying in infants and babies
- Upper airway obstruction - stridor, drooling, difficulty swallowing
- It may indicate peritonsillar abscess, or retropharyngeal abscess (usually present in children below age of 5 and can cause mediastinitis if left untreated)
- Influenza - fever and myalgia are prominent
- Strep throat - severe sore throat; absence of cough, sneezing, and nasal discharge
What are the clinical features of a common cold in a younger child?
- Restlessness
- Nasal congestion, nasal discharge, sneezing, cough
- Poor feeding, breathing problems, sleep disturbance
- Vomiting
- Fever
What examinations would a GP do to a child or infant with a common cold?
- Check temperature
- Examine:
- Fontanelle - a bulging fontanelle with high-pitched crying may indicate meningism
- Cervical lymph nodes - enlarged
- Ears - signs of acute otitis media - red, cloudy, bulging eardrum
- Throat - signs of pharyngitis
What is the management for a common cold?
- Reassure the person that the common cold is self-limiting and complications are rare, and that no treatments are available to cure the common cold
- Reassure them that the common typically lasts 1 weeks for adults and 10-14 days for younger children, although the cough may last for up to 3 weeks
- Advise that Abx and antihistamines are ineffective and may cause side effects
- Advise that transmission of the common cold cannot be completely prevented, but practising good hygiene measures may help limit spread e.g. washing hands frequently, avoid sharing of towels, avoid sharing of toys with an infected child
-
Symptom relief + rest + adequate fluid
- Steam inhalation e.g. sitting in a bathroom with a running hot shower
- Nasal saline drops to relieve nasal congestion
- Gargling with salt water to relieve sore throat or nasal congestion
- Intranasal decongestants, tho prolonged use may cause rebound congestion
-
Paracetamol/ ibuprofen as antipyretic and analgesic
- For children - advise the carer to continue only as long as the child appears distressed. Consider changing to another agent if the child’s distress is not alleviated. Not to give both agents simultaneously; advise to take ibuprofen with caution if you have asthma
When should a GP follow-up people with a common cold?
- If symptoms are worsening or persisting
- People with risk factors for complications
- Advise parents to return if their child develops dehydration, prolonged fever, or laboured breathing
