Cough is a physiologic mechanism for clearing the airways, and is the most common chief complaint among persons presenting to health-care providers in the United States. The efficacy of cough depends on its etiology and the biophysical mechanics of the patient, including respiratory muscle strength, ciliary mobility, bronchial compliance, and mucus rheology.

 In children, as in adults, cough may be a warning sign of disease, and many coughs have characteristic sounds and presentations that can guide clinicians to an appropriate diagnosis and treatment plan.

Continue Reading

Brian Wingrove, PA-C practices with Georgia Pediatric Pulmonology Associates in Atlanta and Children’s Healthcare of Atlanta at Scottish Rite.

HOW TO TAKE THE POST-TEST: Click here after reading the article to take the post-test on


  1. Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest . 2006;129(Suppl 1):1S-23S. Available at
  2. Chung KF, Widdicombe JG. Boushey HA, eds. Cough : Causes, Mechanisms, and Therapy . Malden, Mass.: Blackwell Publishing LTD;2003: 3-7.
  3. McCool FD. Global physiology and pathophysiology of cough: ACCP evidence-based clinical practice guidelines. Chest . 2006;129(1_suppl):48S-53S. Available at
  4. Kauffman F. Varraso R. The epidemiology of cough. Pulm Pharmacol Ther . 2011;24(3):289-294.
  5. American Academy of Pediatrics. Withdrawal of cold medicines: addressing parent concerns. Available at

  6. Paul IM, Yoder KE, Crowell KR, et al. Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents. Pediatrics . 2004;114(1):e85-e90. Available at
  7. Malhotra A, Krilov LR. Viral Croup. Viral Croup. Pediatr Rev . 2001;22(1):5-12.
  8. Leung AKC, Kellner JD, Johnson DW. Viral croup: a current perspective. J Pediatr Health Care . 2004;18(6):297-301.
  9. Bjornson CL, Klassen TP, Williamson J, et al. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. 2004;351(13):1306-1313. Available at
  10. American Academy of Pediatrics. Respiratory syncytial virus. In: Red Book: 2012 Report of the Committee on Infectious Diseases . 29th ed. Elk Grove Village, Ill.: Pickering LK; 2012.
  11. Goodman GG, Wojtczak HW, Welliver RC Sr. Respiratory 
Syncytial Virus: a Frontline Pediatrician’s Guide to Effective Prevention 
and Treatment . Vindico Medical Education CME Monograph. March 2012-March 2013.
  12. Mandelberg A, Tal G, Witzling M, et al. Nebulized 3% hypertonic saline solution treatment in hospitalized infants with viral bronchiolitis. Chest . 2003; 123(2):481-487. Available at
  13. Sarrell E, Tal G, Witzling M, et al. Nebulized 3% hypertonic saline solution treatment in ambulatory children with viral bronchiolitis decreases symptoms. Chest . 2002;122(6):2015-2020. Available at
  14. Weinberger M. The habit cough syndrome and its variations . Lung. 2012;190(1):45-53.
  15. Block SL, Cohen SA, Lieri MB, Skoner DP. Pediatric Asthma: Current Perspectives on Individualized Treatment to Optimize Patient Care . Vindico Medical Education CME Monograph. December 2011-December 2012.
  16. National Asthma Education and Prevention Program Expert 
Panel Report 3. Guidelines for the Diagnosis and Management of 
Asthma (EPR-3) . National Heart, Lung, and Blood Institute. NIH Publication Number 08-5846; 2007. Available at
  17. Juntunen-Backman K, Kajosaari M, Laurikainen K, et al. Comparison of Easyhaler metered-dose, dry powder inhaler and a pressurised metered-dose inhaler plus spacer in the treatment of asthma in children. Clinical Drug Investigation . 2002;22(12):827-835.
  18. Qureshi F, Zaritsky A, Poirier MP. Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma. J Pediatr . 2001;139(1):20-26.
  19. Danov Z, Schroth MK. Respiratory management of pediatric patients with neuromuscular disease. Pediatr Ann . 2010;39(12):769-776.
  20. Boitano LJ. Equipment options for cough augmentation, ventilation, and noninvasive interfaces in neuromuscular respiratory management. Pediatrics . 2009;123(Suppl 4):S226-S230. Available at
  21. Centers for Disease Control and Prevention. Pertussis (Whooping Cough). Available at

  22. Devkota BP. Pertussis test: collection and panels. Medscape. Available at

  23. Faulkner A, Skoff T, Martin S, et al. Pertussis. In: Manual for the Surveillance of Vaccine-Preventable Diseases . 5th ed. Atlanta, Ga.: Centers for Disease Control and Prevention; 2011: chap 10-1. Available at

All electronic documents accessed April 15, 2014.