in this tutorial you will learn how to take a medical history from a patient that presented mainly with cough following simple rules. Children under four should not have cough medicine. 1. Character/circumstance: Productive or not, hacking, hemoptysis. Introduce yourself to the patient including your name and role. While cough often suggests pathology of the upper or lower airway, non-respiratory causes should also be considered. The colour, volume and consistency of the sputum. •Associated symptoms •Timing? 3. The frequency & length of coughing episodes, and whether it varies throughout the day. Clipping is a handy way to collect important slides you want to go back to later. History and physical examination are paramount in the diagnosis of cough. Provide the patient with enough time to answer and avoid interrupting them. Whether the cough is associated with any other symptoms. Can you tell me more about feeling breathless? Cough History Taking 1. Patient instructions. Shortness of breath – History Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES Introduction (WIIPP) Wash your hands Introduce yourself: give your name and your job (e.g. Ainslie G. Assessment of cough. What painkillers have you been taking? Moist cough Suggestive of LRTI, COPD exacerbation or bronchiectasis; Dry Cough Suggestive of viral illness, asthma, GI reflux, restrictive lung disease or ACE inhibitors; Long paroxysms of ‘whooping’ Suggestive of pertussis (whooping cough… Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks’ duration) should include a focused history and physical examination, and in most patients, chest radiography. Dr. Louise Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and date of … Key Symptom Indicators for Considering a Diagnosis of Asthma First, seek potential alarm features that could represent serious illness. Running Time: 16:29. Clinicians should include cough drop use in history taking of patients with persisting cough illnesses. With a shortness of breath history, you will specifically want to enquire about exercise tolerance, cough, wheeze, chest pain and haemoptysis. Asks about symptoms, smoking, and personal and family history of respiratory disease. Acute cough is most commonly associated with the common cold, but it also can be associated with life-threatening conditions (e.g., pulmonary embolism, congestive heart failure, pneumonia). Communicate the purpose and value of a thorough respiratory history and … History of any of the following: Cough (worse particularly at night) Recurrent wheeze Recurrent difficulty in breathing Recurrent chest tightness Lingering cough after a cold. • Do you bring anything up? OSCE 5 presents a clinical encounter of a 45-year-old dispute mediator who presents with a complaint of a cough that has lasted for over 1 week. Second, determine the duration of the cough to narrow the differential diagnosis. A. Shawka. Taking a Respiratory History Every non-emergent assessment should begin by introducing yourself to the patient; provide your name, credentials and your role within the care team. Dr. Loiuse Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and … -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------. History Taking Series (12) Analysis of cough Abbas A. Senior Lecturer Gemma Hurley uses a mock patient to take you through the principles of obtaining a clinical history for www.NurseLedClinics.com. General Examination - OSCE (Y3 Medical Students), No public clipboards found for this slide. Exam includes checking weight and height, and listening to heart and lungs. ; At some point during the encounter, start coughing uncontrollably and observe whether the examinee offers you a drink of water and/or a tissue. Cough is a non-specific symptom that may occur acutely or be present over a prolonged period of time. Exacerbating/alleviating factors: Look for triggers (e.g., only at work or after mowing lawn). If you continue browsing the site, you agree to the use of cookies on this website. Allergies. Other drugs which may have relevance in respiratory disease - eg, angiotensin-converting enzyme (ACE) inhibitors (cough). Introduce yourself, identify your patient and gain consent to speak with them. Symptoms and Causative Agent … In its July 9, 2010 Morbidity and Mortality Weekly Report (MMWR), the Centers for Disease Control and Prevention noted that pertussis (whooping cough) cases reported to the California Department of Health between January 1 and June 30 had increased by 418% over those reported during the … Past medical history. You can change your ad preferences anytime. Use of inhalers (assess compliance and technique). Angiotensin-converting enzyme inhibitors (ACE inhibitors) like lisinopril, captopril, and enalapril are antihypertensive medications. Does anything make it better or worse? Over-the-counter (OTC) cough and cold medicines are safe and effective when they’re used as directed. Introduction (WIIPP) Wash your hands; Introduce yourself: give your name and your job (e.g. When evaluating patients with cough, it is important to pay attention to several aspects in the history that involve the duration, quality, severity, and timing of the cough. Patients with lung disease often complain of the following symptoms: dyspnea/shortness of breath, cough, sputum production, fatigue, exercise intolerance, chest tightness or chest pain. Note: there is a “thoracic” set of questions you can ask for chest pain, cough, dyspnea. Not only does it cause discomfort for the child, cough also elicits stress and sleepless nights for their parents. It is also an important presenting symptom for a variety of disorders, some of which are serious and life threatening. Respiratory History Taking Introduction. CLINICAL APPROACHTO A PATIENT WITHCOUGH… HISTORYTAKING 2. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. … ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------. •Onset? Subjects •How to take a medical history from a patient that presented mainly with cough? Cough When taking a history of a cough, ask the patient: • How long have you been coughing for? Further research into potential mechanisms is warranted. The physician should ask about associated symptoms. In chronic cough and cough with red flag symptoms, thoracic x-ray and pulmonary function testing should be considered at an early stage References: ; You are not aware of the meanings of medical terms (e.g., spirometry) and ask for clarification if the examinee uses them. A. Shawka 2. A good history is one which reveals the patient's ideas, concerns and expectations as well as any accompanying diagnosis. Cough severity in some individuals may be negatively influenced by the amount of menthol consumed via cough drops. Nevertheless, some people on ACE inhibitors develop a… Includes checking fingers, legs, and feet for swelling. History Taking – Overview. Suggestive of upper respiratory tract infection. The doctor's agenda, incorporating lists of detailed questions, should not dominate the history taking. Characteristic of smoker’s cough (chronic bronchitis). • Have you noticed any blood in your sputum? Whether the cough is moist, dry or productive. But taking too much of them -- on purpose or by accident -- can make you feel high. Cough is a very common presenting complaint of patients. Your electronic clinical medicine handbook. Wash your hands and don PPE if appropriate. Abbas A. Analysis of dyspnea (History Taking) •Site? Has it improved or worsened? Continuing Medical Education. Explains risk factors. Cough . Go through the questions and memorise them, for coughing is one of the most common symptom of disease. Character Whether the cough is moist, dry or productive. Respiratory History and Physical Exam . See our Privacy Policy and User Agreement for details. •Relieving? Protectivemechanism Seeks MEDICAL CARE Discomfort from cough itself Interference with normal lifestyle Concern for cause of cough 3. Analysis of cough History Taking of Cough. 2. 2009 Mar 19;27(2):68. Background Cough is a common indication of respiratory illness and is one of the more common symptoms of children seeking medical attention. Listening is at the heart of good history taking. The first step in the treatment of acute cough is to determine if the cause of the cough is one of these serious conditions or an acute upper respirator… Looks like you’ve clipped this slide to already. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Suggestive of pneumonia or bronchiectasis, Suggestive of infection, chronic bronchitis, lung cancer or PE, Suggestive of bronchiectasis, lung abscess or necrotizing pneumonia. An acute cough lasts less than 3-weeks and the most common causes are the common cold, pneumonia and whooping cough. History of Present Illness . Target questions. ACE inhibitors are effective at lowering blood pressure and often preferred to other options like beta-blockers (think propanolol). Act like your cough really annoys you. Presenting complaint. • When do you cough? … ... history-taking skills: Students should be able to obtain, document and present an age-appropriate medical history, that differentiates among … Verify the identity of the patient and her reason for seeking care. History taking 1. If you have a cold or the flu, antihistamines may work better than non-prescription cough medicines. The physician should ask about associated symptoms. History Taking Series (12) Use of steroids (some measure of severity in asthma). •Characteristics? 1. Designed to test clinical reasoning skills, this video provides opportunities to answer questions, practice history taking, and develop an assessment and differential … Use the checklists below for history… Earlier, we discussed how to take Clinical History Taking in medical words, and Respiratory system examination, while in this blog, we will reveal everything that can be asked about Cough to reach the diagnosis. History History of present illness should cover duration and quality of cough (barky, staccato, paroxysmal) and onset (sudden or indolent). Whether the cough has been going on for days, weeks, months or years. If you continue browsing the site, you agree to the use of cookies on this website. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Ask about all allergies including, for example, … Focused History . Water can help ease your cough - whether you drink it or add it to the air with a steamy shower or vaporizer. A thorough history and physical exam is required to identify other signs and symptoms to lead to a … Have you had shortness of breath in the past? What colour is it? Search pattern for Chest X-ray, How to read CXR systematically? Close history taking and physical examination are sufficient to diagnose the cause of an acute cough without red flag symptoms! Note the similarities. Before we dive into the clinical approach to cough, let us review the respiratory physiolo… See our User Agreement and Privacy Policy. Whether the cough is triggered by anything. History History of present illness should cover duration and quality of cough (barky, staccato, paroxysmal) and onset (sudden or indolent). Suggestive of LRTI, COPD exacerbation or bronchiectasis, Suggestive of viral illness, asthma, GI reflux, restrictive lung disease or ACE inhibitors. History of Presenting Complaint. 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