Chronic cough referral checklist

Urgency tier

• Hemoptysis.
• Unintentional weight loss or persistent fever.
• Significant dyspnea, hypoxia, or abnormal vital signs.
• Abnormal chest x-ray suggesting malignancy or infection.
• Immunosuppression or known lung disease with rapid decline.

Minimum pre-referral workup

• Duration longer than 8 weeks and smoking or vaping history.
• Medication review, including ACE inhibitor exposure.
• Chest x-ray report within the past year.
• Spirometry with bronchodilator response if available.
• Assessment of upper airway symptoms and reflux history.

Referral packet checklist

• Onset, pattern, and triggers for cough.
• Smoking history, occupational exposures, and travel.
• Prior trials (inhalers, reflux therapy, nasal therapy) and response.
• Chest imaging and spirometry results.
• Current medications and comorbidities (asthma, GERD).

Pre-referral optimization tasks

• Optimize inhaler technique and trigger-avoidance counseling where appropriate.
• Review smoking and vaping cessation supports and first-line reflux or upper-airway measures.
• Confirm return precautions for hemoptysis, worsening dyspnea, or clinical deterioration.

References

• Canadian Lung Association Chronic cough (opens in a new tab)

Something out of date or unclear? Suggest an update. Leave out any patient details.