• Ask the patient to rate cough frequency, severity and level of associated distress or anxiety.

 

  • Explore:
    • understanding of the reasons for cough
    • fears (including fear of choking)
    • impact on:
      • functional abilities (including continence)
      • quality of life
      • families and carers.

 

  • Clarify:
    • pattern, character and duration of cough
    • precipitating/alleviating factors for cough
    • associated symptoms
    • occupational history.

 

  • Look for any potentially reversible causes of cough, such as:
    • infection
    • pleural or pericardial effusion
    • pulmonary embolism
    • gastro-oesophageal reflux
    • bronchospasm.

 

  • Determine if treatment of the underlying disease is appropriate. Seek advice if in doubt.
  • Assess character of sputum and consider sputum culture if necessary. Refer to tables in the management section.
  • Consider appropriate imaging.