Diagnosing a Cough

Dr. Jim explains the important difference between four types of coughs.

Jim: So that said, let's try this, this first. This is going to be a dry cough. listen to this one. So, Christina does it sound like that one? Christina: Pretty much it's getting there. Jim: Okay. Christina: That's a pretty bad one. Jim: Okay, that was a pretty dry cough. Now some coughs are, I think you said that there's may be some flem coming out. So, this next cough is more of a flemmy wet cough. Now, you can start to hear that their child has sounds like there is a little mucous. Here she is coughing up. Christina, is Jacky your daughter? Is she coughing up anything? Christina: She is coughing up a yellow which mucous. At one point, should I be concerned about the color or what does the color mean? Jim: Now before we get to mucous, I want to cover some of the other really important coughs. Those first two coughs we covered, you know, it really depends on the frequency, how often you are coughing, coughing once or twice a day, I am not worried about no matter what it sounds like. but frequent coughing, every few seconds for non stop, for an hour, for hours, that's when I really worry about a cough, almost no matter what it sounds. But another cough... Travis Stork: Jim, just to interject there. You know, dry coughs are really common with flu. That wet cough is more common with the bronchitis or something like that. Jim: Exactly you are right. Now, one cough that is can be an emergency is croup and so we are going to listen to that. That is classic croup. I can diagnose it over the phone very easily and that can be an emergency because, what's causing the croup is an inflammation of the vocal cords and they swell up and they can swell so much that, the child actually can't breathe. And what's classic about croup is that kind of barky cough, plus the what's called the strider. At the end of the cough you heard that, the little kind of it's almost a whoopy sound, but it's not the whooping cough. It's the, we call a strider and that's something that's important to listen for. This is not the... Travis Stork: I want to clarify there. Kids get croup all the time and if all they are doing is exhibiting that cough and they look fine otherwise, you don't need to stress out as a mom. It can progress, but when your child is going to show symptoms of having some difficulty breathing, they are going to look sick. Croup is so common and there are medicines that we can use a steroid to help. Jim: Or even just get them in the steam. You can do at home. Put him in the hot steamy shower in the bathroom or if the cool night air, if it is foggy out, that usually will kind of settle down a croup. When I worry about it, it's if there kind of relaxed but still making that hard time breathing sound, if they are doing that. Travis Stork: But good evidence, if you have a croupy cough to get in touch with your pediatrician, because they will benefit from dexamethasone, which is steroid treatment that's very effective. Jim: Now, this last one is called is the whooping cough. It is pretty common. Now, is that, you know, people don't think that whooping cough is very common. It's very common especially in adults. Adults may not know they have it, because, they don't get that whoop. but they give to a child who hasn't been vaccinated yet and then they cough so hard, have these long coughing spells and then they are so out of breath, and at the end they do that, they gasp for breath and that's where the whoop comes in.