Sep 25, 2012 - Taxi drivers get flu shots to deal with 'coughing and sneezing'. Department of Public Health and the University of Chicago Medicine. Acute cough, which often follows an upper respiratory tract infection, may be initially disruptive but is usually. Cabdrivers® (dextromethorphan, menthol).

Because acute cough has a different range of causes in adults than it does in children, adults should be assessed and treated differently. The American College of Chest Physicians’ evidence-based clinical practice guidelines recommend that patients with acute cough be divided into children (younger than 15 years of age) and adults (15 years of age or older). Also, people with underlying and chronic diseases or compromised immune systems should be considered and treated differently; primary care clinicians will have no difficulty recognizing such patients. Mr John Smith, a 37-year-old taxi driver, comes to see you on Thursday evening as a drop-in patient. Kukla amigurumi spicami marini golden mk live. He complains of a cough that has been bothering him for 9 days. He felt a bit shivery when it began, but that has passed. The cough is worse at night but it is also present during the day.

He is coughing up slight amounts of yellow-green sputum, once with a slight streak of blood. He feels slightly under the weather because the cough is hindering his sleep. During the past 5 years, you have seen him 3 times. Once he had an ingrown toenail, once he had an acute back strain (helping a passenger unload at the airport), and once he had tonsillitis.

He is not currently taking any medication and has no chronic diseases. His patient record mentions that he is a smoker. Epidemiology and population at risk Acute cough is one of the most common presentations in general practice. This type of cough, also described as acute bronchitis, is the fifth most common new presentation to FPs in Australia and the United States.

Figures from the United Kingdom suggest there are about 50 cases per 1000 people each year, and acute cough leads to 10 ambulatory visits per 1000 visits each year in the United States. Evidence from such general practice reports and the US and UK morbidity surveys shows that the overwhelming majority of acute coughs are infectious in origin. Mr Smith’s story suggests an acute respiratory tract infection. He has no risk factors for serious respiratory disease, although you note he is a smoker and you do not know whether he has asthma. His job entails long hours in a confined space with many different people, which would certainly increase his risk of picking up an infection. You question him further. Distribution of causes of acute cough among adults in typical general practice COPD—chronic obstructive pulmonary disease.

Data from McCormick et al. Mr Smith says he does not, as far as he knows, have asthma or any heart troubles. Although he has smoked for 20 years, he felt fine until 9 days ago; he has not noticed any weight loss, chest pain, or hemoptysis.

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Because recent Health Canada regulations have prohibited smoking in the taxi, he has actually reduced his daily cigarette consumption from 20 to about 10. He has not felt short of breath. The illness came on slowly, over a day or so. He has not traveled out of town for 2 years. Alarm symptoms The patient might report a sudden fever (eg, influenza, pneumonia, severe acute respiratory syndrome [SARS]) or might have been in contact with an infected person (eg, influenza, SARS).