most adults and older children have several respiratory infections each year. respiratory problems can be as minor as the common cold or as serious as pneumonia. they may affect the upper respiratory system (nose, mouth, sinuses, and throat) or the lower bronchial tubes and lungs.
upper respiratory system
the upper respiratory system includes the nose, mouth, sinuses, and throat. when you have an upper respiratory infection, you may feel uncomfortable, have a stuffy nose, and sound very congested. other symptoms include:
pain or pressure in the face.
a runny or stuffy nose. it may lead to blocked nasal passages that cause you to breathe through your mouth.
a sore throat.
a raspy or hoarse voice (laryngitis).
feeling grouchy or restless, having a poor appetite, and being less active than usual.
coughing, especially when you lie down.
fever.
lower respiratory system
the lower respiratory system includes the bronchial tubes and lungs. these types of problems are less common than ones in the upper respiratory system. but their symptoms are usually more severe.
symptoms include:
a cough that lasts through the day and night. it often brings up green, yellow, brown, or grey mucus (sputum) from the lungs.
fever. it may be high with some infections such as pneumonia.
using the neck, chest, and belly muscles to breathe. this causes a "sucking in" between or under the ribs (retractions).
flaring the nostrils when breathing.
chest pain with exertion or when you take a deep breath.
respiratory problems may have many causes.
viral infections
viral infections are the most common cause of upper respiratory symptoms. symptoms often come on quickly (over hours to a day or two) without prior illness. common viral illnesses include colds and influenza (flu).
colds are minor upper respiratory illnesses. they usually go away without treatment. symptoms may include a cough, a mild sore throat, nasal congestion, a runny nose or sneezing, and sometimes a fever.
influenza (flu) symptoms are usually more severe than a cold. symptoms in adults include a fever and body aches. a headache, eye pain, muscle aches, and a cough are also common.
antibiotics aren't used to treat viral illnesses. they don't change the course of viral infections. using an antibiotic when you don't need one exposes you to the risks of an allergic reaction and antibiotic side effects. these side effects include nausea, vomiting, diarrhea, rashes, and yeast infections. antibiotics also may kill helpful bacteria and encourage the growth of antibiotic-resistant bacteria.
bacterial infections
bacterial infections are less common than viral illnesses. they may affect the upper or lower respiratory system. in the upper respiratory system, the most common sites of bacterial infections are the sinuses and throat. in the lower respiratory system, the most common site is the lungs (pneumonia).
bacterial infections are more common in people who smoke, are exposed to second-hand smoke, or have chronic lung disease (such as asthma or chronic obstructive pulmonary disease [copd]) and other chronic medical problems. antibiotics work well to treat most bacterial infections.
allergies
allergies, especially hay fever, are another common respiratory problem. symptoms include sneezing, clear runny drainage from the nose and eyes, itchy eyes or nose, and stuffy (congested) ears and sinuses. the symptoms of allergies often last longer than a typical viral respiratory infection.
asthma
asthma is a chronic disease of the respiratory system. it causes inflammation and narrowing in the tubes that carry air to the lungs (bronchial tubes). the inflammation leads to coughing, wheezing, tightness in the chest, and trouble breathing.
asthma often starts during childhood. it may last throughout a person's life. the cause isn't clearly known. asthma is more common in people who also have allergies.
check your symptoms
do you have a respiratory problem?
respiratory problems can affect the nose, mouth, sinuses, and throat (upper respiratory system) or the bronchial tubes and lungs (lower respiratory system).
yes
respiratory problem
no
respiratory problem
how old are you?
less than 12 years
less than 12 years
12 years or older
12 years or older
are you male or female?
male
male
female
female
the medical assessment of symptoms is based on the body parts you have.
if you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
if your symptoms aren’t related to those organs, you can choose the gender you identify with.
if you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). this will make sure that the tool asks the right questions for you.
pain and swelling in the lower leg can be symptoms of a blood clot.
yes
pain or swelling in one calf
no
pain or swelling in one calf
do you have pain in your ribs or the muscles of your chest?
this type of pain may feel worse when you press on or move the area or when you take a deep breath.
yes
pain in chest wall
no
pain in chest wall
how bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: severe pain
severe pain
5 to 7: moderate pain
moderate pain
1 to 4: mild pain
mild pain
has the chest pain lasted for more than 4 days?
yes
pain in chest wall for more than 4 days
no
pain in chest wall for more than 4 days
are you coughing up mucus, phlegm (say "flem"), or blood from your lungs?
this is called a productive cough. mucus or blood draining down your throat from your nose because of a cold, a nosebleed, or allergies is not the same thing.
yes
coughing up sputum or blood
no
coughing up sputum or blood
are you coughing up blood?
this means blood that is coming up from your chest or throat. blood that is draining down from your nose into your throat (because of a nosebleed, for example) is not the same thing.
yes
coughing up blood
no
coughing up blood
how much blood is there?
a lot of bright red blood [10 ml (2 tsp) or more]
large amount [10 ml (2 tsp)] of bright red blood in sputum
streaks of bright red blood
streaks of bright red blood in sputum
specks or spots of blood
specks or spots of blood in sputum
has this been going on for more than 2 days?
yes
specks or spots of blood in sputum for more than 2 days
no
specks or spots of blood in sputum for more than 2 days
do you take a medicine that affects the blood's ability to clot?
this may include blood thinners and nonsteroidal anti-inflammatory drugs (nsaids) such as aspirin and ibuprofen. these medicines can cause bleeding and can make it harder to control bleeding.
yes
takes medicine that affects blood's ability to clot
no
takes medicine that affects blood's ability to clot
is this cough normal for you because you have a lung problem like chronic bronchitis or emphysema?
some people with chronic lung problems have a productive cough all the time.
yes
typical productive cough
no
typical productive cough
have you been coughing up phlegm for more than 3 days?
note: most people have an average body temperature of about 37°c (98.6°f). but it can vary by a degree or more and still be considered normal. if a low body temperature is the only symptom, it’s usually not something to worry about. but be sure to watch for other symptoms.
high: 40°c (104°f) or higher, oral
high fever: 40°c (104°f) or higher, oral
moderate: 38°c (100.4°f) to 39.9°c (103.9°f), oral
moderate fever: 38°c (100.4°f) to 39.9°c (103.9°f), oral
is the plan helping get your blood sugar under control?
yes
diabetes illness plan working
no
diabetes illness plan not working
how fast is it getting out of control?
quickly (over several hours)
blood sugar quickly worsening
slowly (over days)
blood sugar slowly worsening
do you think that a medicine may be causing your symptoms?
think about whether the symptoms started after you began using a new medicine or a higher dose of a medicine.
yes
medicine may be causing symptoms
no
medicine may be causing symptoms
did you start having trouble breathing after taking a medicine?
this could mean that you're having a bad reaction to the medicine.
yes
breathing problems began after taking medicine
no
breathing problems began after taking medicine
did any other symptoms start after you took the medicine?
yes
possible medicine reaction
no
possible medicine reaction
have you had thick, yellow discharge from your nose for more than 5 days that is not getting better?
this may mean you have a sinus infection.
yes
nasal discharge more than 5 days not getting better
no
nasal discharge more than 5 days not getting better
do you have any pain in your face?
yes
facial pain
no
facial pain
how bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: severe pain
severe pain
5 to 7: moderate pain
moderate pain
1 to 4: mild pain
mild pain
do you have a runny nose, sneezing, and watery eyes without other cold symptoms?
yes
allergy symptoms
no
allergy symptoms
have your symptoms lasted longer than 2 weeks?
yes
symptoms for more than 2 weeks
no
symptoms for more than 2 weeks
many things can affect how your body responds to a symptom and what kind of care you may need. these include:
your age. babies and older adults tend to get sicker quicker.
your overall health. if you have a condition such as diabetes, hiv, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
medicines you take. certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
recent health events, such as surgery or injury. these kinds of events can cause symptoms afterwards or make them more serious.
your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
try home treatment
you have answered all the questions. based on your answers, you may be able to take care of this problem at home.
try home treatment to relieve the symptoms.
call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). you may need care sooner.
if you're not sure if a fever is high, moderate, or mild, think about these issues:
with a high fever:
you feel very hot.
it is likely one of the highest fevers you've ever had. high fevers are not that common, especially in adults.
with a moderate fever:
you feel warm or hot.
you know you have a fever.
with a mild fever:
you may feel a little warm.
you think you might have a fever, but you're not sure.
certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. some examples in adults are:
diseases such as diabetes, cancer, heart disease, and hiv/aids.
long-term alcohol and drug problems.
steroid medicines, which may be used to treat a variety of conditions.
chemotherapy and radiation therapy for cancer.
other medicines used to treat autoimmune disease.
medicines taken after organ transplant.
not having a spleen.
symptoms of difficulty breathing can range from mild to severe. for example:
you may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
it may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
severe trouble breathing means:
you cannot talk at all.
you have to work very hard to breathe.
you feel like you can't get enough air.
you do not feel alert or cannot think clearly.
moderate trouble breathing means:
it's hard to talk in full sentences.
it's hard to breathe with activity.
mild trouble breathing means:
you feel a little out of breath but can still talk.
it's becoming hard to breathe with activity.
pain in adults and older children
severe pain (8 to 10): the pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
moderate pain (5 to 7): the pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. moderate can also mean pain that comes and goes even if it's severe when it's there.
mild pain (1 to 4): you notice the pain, but it is not bad enough to disrupt your sleep or activities.
it is easy for your diabetes to become out of control when you are sick. because of an illness:
your blood sugar may be too high or too low.
you may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
you may not know how to adjust the timing or dose of your diabetes medicine.
you may not be eating enough or drinking enough fluids.
an illness plan for people with diabetes usually covers things like:
how often to test blood sugar and what the target range is.
whether and how to adjust the dose and timing of insulin or other diabetes medicines.
what to do if you have trouble keeping food or fluids down.
when to call your doctor.
the plan is designed to help keep your diabetes in control even though you are sick. when you have diabetes, even a minor illness can cause problems.
temperature varies a little depending on how you measure it. for adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.
oral (by mouth) temperature
high: 40°c (104°f) and higher
moderate: 38°c (100.4°f) to 39.9°c (103.9°f)
mild: 37.9°c (100.3°f) and lower
a forehead (temporal) scanner is usually 0.3° c (0.5° f) to 0.6° c (1° f) lower than an oral temperature
ear temperature
high: 40.6°c (105°f) and higher
moderate: 38.6°c (101.4°f) to 40.5°c (104.9°f)
mild: 38.3°c (101°f) and lower
armpit (axillary) temperature
high: 39.5° c (103° f) and higher
moderate: 37.5°c (99.5°f) to 39.4°c (102.9°f)
mild: 37.4° c (99.4° f) and lower
symptoms of a severe allergic reaction (anaphylaxis) may include:
the sudden appearance of raised, red areas (hives) all over the body.
rapid swelling of the throat, mouth, or tongue.
trouble breathing.
passing out (losing consciousness). or you may feel very light-headed or suddenly feel weak, confused, or restless.
a severe reaction can be life-threatening. if you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. even if the symptoms are mild at first, they may quickly become very severe.
symptoms of a heart attack may include:
chest pain or pressure, or a strange feeling in the chest.
sweating.
shortness of breath.
nausea or vomiting.
pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
light-headedness or sudden weakness.
a fast or irregular heartbeat.
for men and women, the most common symptom is chest pain or pressure. but women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.
symptoms of serious illness may include:
a severe headache.
a stiff neck.
mental changes, such as feeling confused or much less alert.
extreme fatigue (to the point where it's hard for you to function).
shaking chills.
seek care today
based on your answers, you may need care soon. the problem probably will not get better without medical care.
call your doctor today to discuss the symptoms and arrange for care.
if you cannot reach your doctor or you don't have one, seek care today.
if it is evening, watch the symptoms and seek care in the morning.
based on your answers, you may need care right away. the problem is likely to get worse without medical care.
call your doctor now to discuss the symptoms and arrange for care.
if you cannot reach your doctor or you don't have one, seek care in the next hour.
you do not need to call an ambulance unless:
you cannot travel safely either by driving yourself or by having someone else drive you.
you are in an area where heavy traffic or other problems may slow you down.
call 911 now
based on your answers, you need emergency care.
call 911 or other emergency services now.
sometimes people don't want to call 911. they may think that their symptoms aren't serious or that they can just get someone else to drive them. but based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
call 911 now
based on your answers, you need emergency care.
call 911 or other emergency services now.
after you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. wait for an ambulance. do not try to drive yourself.
sometimes people don't want to call 911. they may think that their symptoms aren't serious or that they can just get someone else to drive them. but based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
swallowed or inhaled objects
post-operative problems
respiratory problems, age 11 and younger
self-care
here are some things you can do at home to help you feel more comfortable when you have mild to moderate respiratory symptoms.
hot fluids, such as tea or soup, may help relieve congestion in your nose and throat.
if you have a productive cough, fluids may help thin the mucus in your lungs so your cough can clear it out.
get extra rest.
let your symptoms be your guide. if you have a cold, you may be able to stick to your usual routine and just get some extra sleep.
cough to clear your lungs.
let yourself cough if you have a cough that brings up mucus from the lungs. coughing can help prevent bacterial infections. people who have chronic bronchitis or emphysema need to cough to help clear mucus from their lungs.
use saline (salt water).
for a sore throat, gargle at least once each hour with warm salt water. use 1/2 teaspoon (2.5 ml) salt mixed in 1 cup (250 ml) warm water. this can reduce swelling and discomfort.
try a vaporizer or humidifier to add moisture to the room. cool mist may help relieve symptoms. follow all cleaning instructions and precautions for the machine.
be careful with over-the-counter medicines.
carefully read and follow all directions on the medicine bottle and box. be aware of possible side effects. and make sure to keep medicine out of the reach of children.
if you use a decongestant nasal spray, don't use it longer than the label says. overuse may lead to a rebound effect. this causes the mucous membranes to become more swollen than they were before you started using the spray.
if you have a dry, hacking cough that doesn't bring up any sputum, ask your doctor or pharmacist about an effective cough suppressant medicine.
non-prescription medicines may not work very well for respiratory problems. and some of these medicines can cause problems if you use too much of them. it's important to use medicines correctly.
be careful with natural health products.
if you decide to try a natural health product such as echinacea or zinc, don't take more than the maximum recommended dose. if you have another health problem or take prescription medicines, talk with your doctor before you take an alternative medicine or natural health product.
using decongestants
here are some precautions to take when using decongestants.
decongestants are not recommended for children younger than age 6. if your child's doctor tells you use these medicines, always follow the directions about how much to use based on age and in some cases weight. not everyone needs the same amount of medicine.
decongestants can cause problems for people who have certain health problems, such as heart disease, high blood pressure, glaucoma, diabetes, or an overactive thyroid. decongestants may also interact with some drugs, such as certain antidepressants and high blood pressure medicines. read the package carefully or ask your pharmacist or doctor to help you choose the best decongestant for you.
drink extra fluids when you are taking cold and allergy medicines.
don't use decongestant nasal sprays, drops, or gels more times in one day or for more days in a row than the label says. overuse can cause rebound congestion. it makes your mucous membranes swell up more than before you used the spray.
if you are pregnant or breastfeeding, check with your doctor or pharmacist before using a decongestant.
when to call for help during self-care
call a doctor if any of the following occur during self-care at home:
author: healthwise staff clinical review board all healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
clinical review board all healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
