Respiratory Problems, Age 12 and Older
Respiratory Problems, Age 12 and OlderSkip to the navigationTopic OverviewMost 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. See a picture of the
respiratory system. Upper respiratory systemThe 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 of an upper respiratory infection
include: - Facial pain or pressure.
- A runny or
stuffy nose, which may lead to blockage of the nasal passages and cause you to
breathe through your mouth.
- A sore
throat.
- Laryngitis.
- Irritability, restlessness, poor appetite, and decreased
activity level.
- Coughing, especially when lying
down.
- Fever that occurs suddenly and may reach
103°F (39°C) or higher.
Lower respiratory systemThe lower respiratory system
includes the bronchial tubes and lungs. Respiratory problems are less common in
the lower respiratory system than upper respiratory system. The
symptoms of a lower respiratory (bronchial tubes and lungs) problem usually are
more severe than symptoms of an upper respiratory (mouth, nose, sinuses, and
throat) problem. Symptoms of lower respiratory system infections
include: - Cough, which continues throughout the day and
night, often producing green, yellow, brown, or gray mucus (sputum) from the
lungs.
- Fever, which may be high with some lower respiratory system
infections such as pneumonia.
- Difficulty breathing. You may notice:
- Shortness of breath.
- Grunting,
which is heard during the breathing out (exhaling) phase of
breathing.
- Wheezing.
- Flaring the nostrils and using
the neck, chest, and abdominal muscles to breathe, causing a "sucking in"
between or under the ribs (retractions).
- Chest pain with exertion or when you take a deep
breath.
Respiratory problems may have many causes. Viral infectionsViral infections are the most common
cause of upper respiratory symptoms. Symptoms of a viral illness 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
that usually go away without treatment. Symptoms may include cough, mild sore
throat, nasal congestion, runny nose or sneezing, and occasionally a fever.
- Influenza (flu) symptoms are usually more severe than
a cold. The key symptoms in adults are fever and
body aches. Headache, eye pain, muscle aches, and cough are also common. For
more information, see the topic
Influenza (Seasonal Flu).
Antibiotics are not used to treat viral illnesses and do
not alter the course of viral infections. Unnecessary use of an antibiotic
exposes you to the risks of an
allergic reaction and antibiotic side effects, such as
nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may
kill beneficial bacteria and encourage the development of dangerous
antibiotic-resistant bacteria. Bacterial infectionsBacterial infections may develop
after a viral illness, such as a cold or influenza, and are less common than
viral illnesses. Bacterial infections may affect the upper or lower respiratory
system. Symptoms tend to localize to one area. 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 smokers, people exposed to secondhand smoke, and people with chronic
lung disease (such as
asthma or chronic obstructive pulmonary disease [COPD]) and other chronic medical problems. Antibiotics
can effectively treat most bacterial infections. AllergiesAllergies, 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. For more information, see the topic
Allergic Rhinitis. AsthmaAsthma 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 difficulty breathing,
wheezing, tightness in the chest, and cough. Asthma often begins during childhood and may last throughout a person's
life. The cause of asthma is not clearly known. It is more common in people who
also have allergies. For more information, see the topic
Asthma in Children or
Asthma in Teens and Adults. Check your symptoms to decide if and when
you should see a doctor. Check Your SymptomsDo 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). How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Have you swallowed or inhaled an object? Yes Swallowed or inhaled object No Swallowed or inhaled object Have you had surgery in the past 2 weeks? Surgery can cause problems that make you cough. This is more likely if you have had a bad reaction to something in the past. Yes Possible severe allergic reaction (anaphylaxis) No Possible severe allergic reaction (anaphylaxis) Are you having trouble breathing (more than a stuffy nose)? Yes Difficulty breathing more than a stuffy nose No Difficulty breathing more than a stuffy nose Would you describe the problem as severe, moderate, or mild? Severe Severe difficulty breathing Moderate Moderate difficulty breathing Mild Mild difficulty breathing Do you have a chronic health problem that affects your breathing, such as asthma, allergies, or COPD? A breathing problem may be more of a concern if you normally do not have breathing problems. Yes Has chronic breathing problems No Has chronic breathing problems Are the breathing problems you're having right now different than what you are used to? Yes Breathing problem is different than usual symptoms No Breathing problem is different than usual symptoms Is your ability to breathe: Quickly getting worse (within minutes or hours)? Breathing problems are quickly worsening Slowly getting worse (over days)? Breathing problems are slowly worsening Staying about the same (not better or worse)? Breathing problems are unchanged Getting better? Breathing problems are getting better Yes Symptoms of serious illness No Symptoms of serious illness Do you have pain or swelling in one calf? 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. 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. How much blood is there? A lot of bright red blood [2 tsp (10 mL) or more] Large amount [2 tsp (10 mL)] 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, such as aspirin, warfarin (such as Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix)? 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? Yes Coughing up sputum for more than 3 days No Coughing up sputum for more than 3 days Do you think you may have a fever? Did you take your temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long have you had a fever? Less than 2 days (48 hours) Fever for less than 2 days At least 2 days but less than 1 week Fever for at least 2 days but less than 1 week 1 week or more Fever for 1 week or more Do you have a health problem or take medicine that weakens your immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Do you have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Is your diabetes getting out of control because you are sick? Yes Diabetes is affected by illness No Diabetes is affected by illness 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? 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? 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, herbal remedies, and supplements 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 TreatmentYou 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:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Ear or rectal temperature - High:
105°F (40.6°C) and
higher
- Moderate:
101.4°F (38.6°C) to
104.9°F (40.5°C)
- Mild:
101.3°F (38.5°C) and
lower
Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) 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 lightheaded 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.
- Lightheadedness or sudden
weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas. 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 TodayBased 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.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Seek Care NowBased 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 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Call 911 NowBased on your answers, you need
emergency care. Call911or 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. Swallowed or Inhaled Objects Postoperative Problems Respiratory Problems, Age 11 and Younger Home TreatmentHome treatment can help you feel
more comfortable when you have mild to moderate respiratory symptoms. - Prevent
dehydration. 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.
- Let yourself cough if you have a cough that brings up mucus
from the lungs. It can help prevent bacterial infections. People who have
chronic
bronchitis or
emphysema need to cough to help clear mucus from their
lungs.
- For a sore throat, gargle at least once each hour with warm
salt water [1 tsp (5 g) of salt in
8 fl oz (240 mL) of water] to
reduce swelling and discomfort. For more information, see the topic
Sore Throat and Other Throat Problems.
- Use a humidifier to add moisture to the air. Use only water in the humidifier.
- For a stuffy nose, use saline spray or nose drops to wash out mucus and germs.
Keep in mind the following guidelines for taking
nonprescription medicine for your symptoms: - Nonprescription 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 is important to
use medicines correctly and to keep them out of the reach of children to
prevent accidental use.
- Check with the doctor before giving decongestants, antihistamines, or other cold and allergy medicines to
children.
- If you use a decongestant nasal spray, don't use it longer than the label says. Overuse may lead to a rebound effect, which 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 does not bring up
any sputum, ask your doctor or pharmacist about an effective cough suppressant medicine. For
more information, see the topic
Coughs, Age 12 and Older.
- If you decide to try a dietary supplement such as echinacea or zinc, do not exceed the maximum recommended dose. If you have another health problem or take
prescription medicines, talk with your doctor before taking an alternative
medicine or supplement. For more information, see the
topic
Colds or Complementary Medicine.
Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
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| Safety tips Be sure to follow these
safety tips when you use a nonprescription medicine: |
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- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Increasing difficulty breathing
develops.
- Wheezing develops.
- New chest pain develops.
- Symptoms last longer than 2 weeks.
- Symptoms become more severe or frequent.
PreventionThere is no sure way to prevent
respiratory illnesses. To help reduce your risk: - Wash your hands often, especially when
you are around people with colds.
- Keep your hands away from your
nose, eyes, and mouth. These are the places where viruses are most likely to
enter your body.
- Do not smoke or use other tobacco products.
Smoking irritates the mucous membranes of the nose, sinuses, and lungs, which
may make them more susceptible to infections. For more information, see the
topic
Quitting Smoking.
- If you live in an area that
has problems with air pollution or smoke from wildfires:
- Stay indoors and avoid breathing in smoke,
ashes, or polluted air.
- Do not exercise outdoors if you smell smoke
or notice irritation of your eyes, nose, or throat.
- Keep your motor
vehicle windows rolled up and the vents closed when driving.
- Avoid cleanup activities, such as raking leaves or
cutting brush.
- Avoid exposure to chemicals. Do not spray or apply
chemicals unless you are wearing protective clothing, such as a
particle-filtering respirator, safety goggles, and gloves.
- Exercise
regularly. For more information, see the topic
Fitness: Getting and Staying Active.
- Get a flu shot (influenza vaccine) each year. For more information, see the topic
Influenza (Seasonal Flu).
- Get a pneumococcal shot if you have chronic lung
disease, such as
asthma or
chronic obstructive pulmonary disease (COPD); if you
smoke; or if you have a
health risk that increases the seriousness of your
symptoms. If you are age 65 or older, it is recommended you get two different types of pneumococcal vaccines.
- Make sure your
immunizations are current, such as pertussis to reduce
your risk of getting
whooping cough. For more information, see the topic
Immunizations.
- For information on
preventing allergies or asthma, see the topic
Allergic Rhinitis or
Asthma in Teens and Adults.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - When did your symptoms start?
- Is your
respiratory problem localized, such as involving only one ear, one side of your
sinuses, or the lungs?
- Did symptoms start as a cold but now appear
to be worse than you would expect from a cold?
- Have you had similar
symptoms before? How were they treated?
- Do you have a productive
cough? Are you coughing up clear, white, green, yellow, or blood-tinged mucus?
How much mucus are you bringing up? Are you coughing up mucus all day long or
mostly at nighttime?
- Have you had fever and chills?
- Are
you wheezing, or do you have new or worsening shortness of
breath?
- Do you have a severe headache, earache, or sore
throat?
- Do any other members of your family or work group have
similar symptoms?
- Have you recently been exposed to large amounts
of dust, fumes, smoke, or chemicals?
- Do you smoke or use other
tobacco products?
- Have you recently used an indoor hot tub, pool,
or spa?
- What home treatment have you tried? Did it help?
- What prescription, nonprescription, or alternative medicines have
you tried? Did they help?
- Have you recently traveled inside or
outside of your home country?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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