Respiratory in General Practice
Respiratory symptoms are common in primary care. This section brings together the presentations and conditions a Physician Associate should be familiar with when working in general practice, while recognising when urgent escalation is required.
Common Presentations
These are some of the respiratory presentations you are likely to encounter regularly in general practice.
Cough
Think about duration, infective symptoms, smoking history, asthma or COPD, reflux, medication causes, haemoptysis and malignancy red flags.
Breathlessness
Assess onset, severity, oxygen saturation, respiratory effort and whether the cause may be respiratory, cardiac, thromboembolic or systemic.
Wheeze
Consider asthma, COPD, infection and less common causes while assessing severity and looking for features of acute deterioration.
Haemoptysis
Clarify the amount and duration and consider infection, PE, bronchiectasis, malignancy and other significant causes.
Chest Pain
Do not assume chest pain is respiratory. Consider cardiac, thromboembolic, gastrointestinal and musculoskeletal causes as part of the assessment.
Fever with Respiratory Symptoms
Consider viral infection, pneumonia, sepsis and whether the patient has risk factors for complications or requires same-day assessment.
Conditions to Be Comfortable With
Select a condition to open the relevant PARA-aligned Mypanotes topic.
Recognise and Escalate
Some respiratory presentations may first appear in general practice but require urgent assessment or emergency escalation.
Severe or Life-Threatening Asthma
Recognise marked respiratory distress, inability to speak normally, exhaustion, hypoxia or other features suggesting severe deterioration.
Respiratory Failure
Significant hypoxia, altered mental state, exhaustion or severe respiratory distress requires immediate escalation.
Pulmonary Embolism
Consider PE with unexplained breathlessness, pleuritic chest pain, haemoptysis, tachycardia or relevant thromboembolic risk factors.
Tension Pneumothorax
Sudden severe breathlessness with haemodynamic compromise is an emergency and requires immediate escalation.
Sepsis
Respiratory infection may be the source of sepsis. Assess the whole patient, not simply the respiratory diagnosis.
Significant Haemoptysis
Large-volume, recurrent or clinically concerning haemoptysis requires urgent assessment and investigation.
Scope and supervision: being familiar with these presentations and conditions does not mean every case should be managed without support. Patient complexity, your competence, local governance and available supervision should guide when you seek senior clinical input or escalate care.