Facilitator notes

Facilitator, please role-play this patient and allow the student/team to collect a focused history. The key elements are reported here, provide generic information when there is no applicable answer below.
After the role-play, provide the History handout to the player.

Olive Greene, 58 years old, non-Aboriginal or Torres Strait Islander.

Opening line: “I am so exhausted of this cough, doctor, please do something”.

You developed a productive cough with yellow sputum about three days ago and it has been getting progressively worse, until you’ve decided to come to ED. It prevents you from sleeping. It sounds like a deep cough, and comes in big fits that leave you dizzy and exhausted. You have noticed the phlegm seems to have some streaks of blood, but didn’t think much about it.

You’ve been feeling very tired. Trying to do house chores or walking the dog makes you feel out of breath. This is a big problem for you, as you normally look after the house and dog after you finish work, because your husband works much longer hours.

You haven’t taken your temperature. You have no chest pain or palpitations. You have no trouble breathing at rest, nor lying down. You haven’t lost any weight, or noticed other changes.

You’ve taken two days off from your work, but it is a small business and they are struggling, as other people got sick with the flu. You have been trying to rest the last few days but it just seems to be getting worse.

You often have a mild dry cough but never experienced a cough this bad before.

Past medical history

You have never been admitted to hospital before. Two years ago, your GP noticed your blood pressure was high, and you now take enalapril 10mg once a day.

You have entered menopause three years ago, and occasionally still have hot flashes, but mostly doing well. You have no children.

Your mother has type 2 diabetes, and your father has hypertension.

Lifestyle and social history

You live in your own home with your second husband and German shepherd dog.

You smoke 15 cigarettes per day, and have been doing so since you were 35 years old. You don’t take any recreational drugs.

Your diet is fairly good, although your doctor recommended you to eat more fruit and less chocolate. You drink a beer about once a week.

You have worked as a mechanic since your late twenties, which can be quite physical. You walk the dog daily for 30 minutes. No structured physical exercise.