Cough is a protective reflex response to airway irritation and is triggered by stimulation of airway cough receptors by either irritants or by conditions that cause airway distortion.

The UK Association for Palliative Medicine (APM) have provided some strategies for managing cough in End-of-Life care in Covid-19 situations:

Cough hygiene

To minimise the risk of cross-transmission cover the nose and mouth with a disposable tissue when sneezing, coughing, wiping and blowing the nose, dispose of used tissues promptly into clinical waste bin, clean hands with soap and water, alcohol hand rub or hand wipes after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions.

Non-pharmacological measures

Provide humidified room air, give oral fluids including honey and lemon in warm water, give cough drops or hard sweets, elevate the head when sleeping, and avoid smoking.

Pharmacological measures

Administer simple linctus, codeine linctus, or morphine sulphate. If all these measures fail, seek specialist advice to discuss use of inhaled sodium cromoglicate or CSCI infusion of morphine sulphate over 24 hours. Locate the suggested doses in the APM guideline attached below.