Scenario 2:

• Peter, 30 year old, requests an Over The Counter medication for a Sinus.
• After gathering information you find out the following information-

• - Symptoms are headache, blocked nose and pressure across the nose
• - Doesn’t have a temperature, or other signs of infection
• - Hasn’t tried anything yet
• - Had this for four days
• - No other medication or medical conditions

What questions did you need to ask to gather the information above
Who is it for?
What symptoms do you have?
How long have you had the symptoms for?
Have you tried anything else for it?
Are you on any other medications/ have any medical conditions/ allergies? Do you suffer with hay
fever?
Any loss of smell? (rhinosinusitis?
Any ear pain?
Any pain around the nose or behind the eyes?
Is the pain worse when you bend over?
Any allergy-related symptoms?
Who is the patient and what do you know about them

Consider Age/Sex of patient/ General appearance (patient look well/unwell)

Gathering Information – Consider how you will phrase the questions below and note what
questions you will ask the patient to gather information

Respiratory Responding to Symptoms workshop

Epidemiology – What is the most likely diagnosis (from initial scenario presented)
Based on the initial presenting symptoms what is the most likely diagnosis? Rhinosinusitis

What other conditions may it be? Rhinitis (sneezing, runny eyes)

Specific questions to aid differential diagnosis – what specific question you will ask patient
and how will you phrase them and why are you asking them?
Specific questions to ask patient
Describe the symptoms? (what questions would you ask to get more information about the
symptoms)

Does the patient have any other symptoms?

Have they tried anything yet?

Are they taking any other medicines?

Have they any other medical conditions?

Are they pregnant/breastfeeding(if relevant)?
What red flags symptoms do you need to rule out?

COVID-19 symptoms
Middle ear pain which fails to respond to analgesia Symptoms which do not resolve with
decongestant therapy

Differential diagnosis and treatment options

What condition do you think the patient is suffering from?
Rhinosinusitis
Treatment options and Explanation
What treatment option have you chosen and why? Consider patient preferences for treatment
options
What would they prefer?

1. Intranasal decongestant spray (Sudafed). Pseudoephedrine can cause insomnia, inclined to

keep you awake.
2. Sinutab – two tablets to be taken every four to six hours, up to 4 times a day. Max. dose is 8
tablets. Contains paracetamol
3. Decongestant + antihistamine
4. Painkiller (paracetamol or ibuprofen)

Respiratory Responding to Symptoms workshop

Explaining treatment option to patient

Note here counselling points you will cover with patient to discuss treatment option
Advise patient on condition they may be suffering
If recommending product -Advise name of medication and how it will help patient. Lifestyle advice
Advise directions
Note here what information you will give the patient for appropriate safety netting
How quickly should the management plan work?
What could indicate that the management plan is not working? Specific symptoms that could indicate
the diagnosis is incorrect? What to do if alarming symptoms arise?