5 Questions to Ask If You Have a Respiratory Infection

Medically reviewed in October 2021

A good friend called me the other night – she’d been coughing for several days and

now she had a fever and chest pain (oh, and it was 11 o’clock at night, which is when these types of symptoms seem to crop up).  She wanted to know if she should go to the ER.  Now, my friend has an ER doctor on speed-dial, which was convenient for her.  But otherwise, when is a cough or respiratory infection bad enough to head for medical help – STAT?

While there’s no one set of rules (and it’s never black or white!), here’s a cheat sheet of questions to ask yourself (or, of course, anyone with these symptoms). If you answer yes to any, you may need ER-level care. 

  1. Severity: Is the cough bad enough that you’re having trouble breathing? Have you started wheezing? Are you breathing rapidly just to get enough air?
  2. Duration: Have your symptoms not gotten better, or especially worsened over 7-10 days? This can be telling, since prolonged courses usually suggest something like pertussis or pneumonia.
  3. Output: Is your cough accompanied by green or thick mucus or blood? You need to seek care immediately, especially if you’re coughing blood.
  4. Other symptoms: Do you feel chest pain or pressure? Are you coughing so severely that it makes you vomit or unable to speak? Has your cough significantly worsened over a few days? Do you have a fever, feel confused or dizzy? Sometimes it’s not the cough alone that’s worrisome, it’s the associated symptoms that suggest a more serious condition.
  5. Other history: Do you have a chronic medical condition such as COPD (emphysema or chronic bronchitis), a history of heart failure or a weakened immune system (for example, a cancer patient on chemotherapy)? It’s no surprise that someone who has a long-term illness is going to be at risk for things like pneumonia or just have a harder time recovering when they get sick. Age is another factor to consider, especially for those age 75 or older. Others to put in the higher risk category are long-term smokers.

As I always tell my patients, if a symptom significantly worries you even if you don’t meet the criteria above, call your doctor or go to the ER.  No one else can judge as well as you, and that’s why we’re here, 24/7, 365 days a year.

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