Chest Pain. If you ever think you may be having a heart attack you should call for an emergency ambulance. Do not delay seeking emergency help.
Self Treatment of Minor Self-Limiting Illnesses. There are many illnesses that are simply managed by rest, fluids and simple ‘over the counter’ (OTC) medicines available from your local chemist. A whole range of viruses, which do not require to be treated by antibiotics, cause many of these illnesses. Antibiotics are completely ineffective against viruses. The following is a short resume of some common adult and childhood illnesses:
Animal Bites. Always consult the Practice nurse. You may require a Tetanus vaccination
Back Pain. Probably the most common reason in Britain for absence from work. The main treatment is simple painkillers and avoiding any movements that exaggerate the pain. Bed rest is not usually necessary and most Physiotherapists would discourage this for more than 24 hours, unless we suspect that you have a disc prolapse, which is extremely unusual. Please ask if you would like a back exercise information sheet. If the pain persists for more than a few days or is particularly severe and disabling, then consult your doctor.
Chickenpox. In the UK we do not have a vaccine programme against chickenpox. Again, it is caused by a virus and is characterised by small raised spots, usually about 2-3 mm in size, which after 24-36 hours begin to crust. The majority of these are situated about the body and head. Itching can be a problem and applying Calamine Lotion or using an anti-histamine such as Piriton Syrup may be useful. Chickenpox is infectious for about 3-4 days before the spots appear and also for about 5 days after the last spot appears. Shingles is the re-activation of the chickenpox virus, which is relatively rare in children but more common in adults. There is usually a band of crusty spots and scabs around the body or head. Shingles can be particularly painful. You may catch chickenpox from shingles, but it is not possible to pass shingles onto someone else.
Child with A Temperature. A child will develop a temperature because of an infection; usually the child will get over such an infection without the use of antibiotics. Viruses cause most childhood infections and these do not respond to antibiotics. The following advice is to help you bring you child’s temperature down and make him/her feel better: Always keep a supply of Paracetamol Syrup (Calpol, Disprol) at home. If your child feels hot and appears unwell, take his/her temperature. The normal temperature is up to 37 degrees centigrade. If you think your child has a temperature, try to lower it as follows:
Give your child Paracetamol (Calpol/Disprol). Give the maximum dosage stated for a child of that age. An alternative or addition is Ibuprofen (Nurofen)
Dress your child in cool clothes, T-shirt and shorts. Much heat is lost through a child’s head, so leave it uncovered. Cool down the room by opening doors and windows.
Give your child plenty of cool drinks, as fluid is lost with a fever. If he/she is reluctant to drink, encourage small amounts from a favourite cup.
Sponging your child down, particularly the head, with a tepid flannel, will make him/her feel better as well as bringing their temperature down. Using tepid water is more effective than using cold water.
Repeat the dose of paracetamol every 4 hours if necessary.
If you child does not improve after giving Paracetamol and sponging, or appears particularly ill, call the doctor.
You will not make your child any worse by taking him/her in a pram to see the doctor. Sometimes the fresh air makes feverish children feel better.
A child with a fever is likely to be restless at night. Offer cool drinks and sponge them down if they wake.
Very rarely a child less than 5 years will have a convulsion with a high temperature. The child suddenly shakes all over and becomes very still. If your child does have a convulsion it should subside in less than 5 minutes, lie the child on his/her side and stay with them while it lasts. If there is another adult in the house, ask them to call the doctor. If not, call the doctor when the convulsion has passed. An emergency ambulance should be called if you are concerned, or if a seizure is prolonged.
Common Childhood Viruses. Many of the childhood viral illnesses such as mumps, measles and rubella are preventable by vaccination in the form of MMR vaccine, which is normally given at around 13 months of age. If you suspect your child has mumps or measles the doctor should be contacted for advice. German measles is a much milder illness than measles. Children usually develop a fairly flat pink rash covering most of the body, arms and legs. It is unusual for this to be itchy. Although German measles is very mild and does not normally cause the patient any problems, it is important to avoid contact with any women who may be pregnant as it can be potentially dangerous to the unborn baby. Anyone who has any concerns regarding this should contact the doctor for advice. The trouble with all illnesses such as mumps, measles, rubella and chickenpox is that patients are actually more infectious before the rash appears. The infectivity remains for mumps until about 8-10 days after the characteristic swelling, for measles again for about 7-10 days after the appearance of the rash and with German measles for about 4-5 days after the appearance of the rash.
Common Cold. Alas, even in this technological world there is no cure for the common cold. It is usually a mild self-limited illness characterised by congestion, sore throats, catarrh, cough etc. Occasionally the catarrh may be slightly discoloured. This is not uncommon and should settle down again after a few days. Simple remedies again include Paracetamol or Aspirin in children over twelve. Some method of decongesting the catarrh is also very useful, this can either be done by:
- Using a proprietary decongestant.
- Try if at all possible not to use nosedrops and certainly not for more than 48 hours as the effect of these tends to be very transient and the nose will block up again on withdrawing them.
- Steam inhalation remains an effective method of breaking up catarrh. Breathing vapours from a bowl of boiling water with Vick, Friars Balsam or Menthol Crystals is helpful (the steam is the active ingredient).
Cuts. Immediately clean the wound as thoroughly as you can with cold water and a little antiseptic solution. Apply gentle pressure with a clean cloth until the bleeding stops. Larger cuts i.e. greater than 1 cm, or deep cuts may require stitching. The doctor may stitch you in the surgery or suggest you go to the local Casualty Department. It is important that your Tetanus booster is up-to-date. This normally lasts for 10 years. You will require a booster vaccination if you are outwith this time or have a particularly dirty wound.
Cystitis. Burning sensation when passing water. Drink plenty of clear fluids. A teaspoonful of Bicarbonate of Soda dissolved in water may help the burning sensation. If symptoms persist for more than 24 hours consult you doctor and bring a urine sample.
Diarrhoea. Diarrhoea again is usually a viral illness and the management is the same as for vomiting. Do not be tempted to take proprietary preparations like Imodium or Lomotil in the first 48 hours of the diarrhoea. If any bugs are irritating the bowel, it is very important that they are eliminated. It is quite common to have tummy cramps with diarrhoea and simple Paracetamol can be taken for this. One or two food poisoning bugs such as Salmonella or Campylobacter also cause diarrhoea. These are usually more severe and if there is any evidence of blood stained diarrhoea you should contact your doctor for further advice.
Earache. Earache is a very common illness due to a simple ear infection or secondary to pressure generated by catarrh. If the pain does not settle within 24 hours of using full dose Paracetamol, or if a child is unwell then consult your doctor.
Fever. High temperatures are very common with a multitude of illnesses. There is a separate section in this booklet for dealing with children who have a fever. The normal body temperature is approximately 37 degrees centigrade. If you find your temperature is high then the following simple advice should be followed:
Headaches. Headaches have a multitude of causes; from simple tension headaches through to migraine. Most will respond to simple over the counter (OTC) remedies such as Paracetamol, Solpadeine, and Nurofen. A tight ‘band-like’ headache is often due to tension. Relaxation may be more useful than painkillers.
Influenza. Flu tends to have similar symptoms to the common cold but is much more severe and you are much more likely to have muscle aches, general lethargy and high fever. Again, rest, plenty of fluids and Paracetamol are the only treatment required. Occasionally some people, particularly those with chest problems, may develop secondary chest infections because of the flu and then require some antibiotic treatment. Vulnerable people i.e. those with chronic bronchitis and emphysema, diabetes, asthma or those aged over 65 , should be protected against flu by obtaining an influenza vaccination which is (usually) available in the surgery from mid-October. Telephone the Practice nurse to enquire about this.
Insect Bites and Stings. Any visible sting should be removed, and an ice pack applied to the area. There are various anti-histamine creams or sprays that can also be purchased from the chemist, but ice will usually be sufficient.
Nose bleeds. Nosebleeds are particularly common, especially in children. The patient should be sat forward with the mouth open and pressure applied just below the bridge of the nose for approximately 10-15 minutes. This will settle the majority of nosebleeds.
Rest. It is very important not to exercise when you have a high temperature. Take the maximum dose of Paracetamol as recommended by the manufacturers instructions. If your temperature remains high you can help this by sponging with tepid or cool water. Cool drinks are also helpful. It is quite safe to bring a child with a temperature to the surgery. In many instances being out in the fresh air will actually help to lower the temperature. A fit is a very rare complication with a very high temperature i.e. above 39.5 degrees centigrade. If you find your child has a very high temperature and you have recently given Calpol, immediately sponge with tepid or cool water. If any rash appears or your child appears unusually lethargic then consult your doctor.
Scalds and Burns. Immediately apply cold water to the affected area and follow this with the application of an ice pack placed on top of a damp cloth. If the burn is large or beginning to blister contact the Practice nurse for dressing advice.
Sore Throats. The majority of sore throats are caused by viruses and do not require any antibiotic treatment. Children should be given plenty of fluids and, if they are in pain or have a temperature, given regular soluble Paracetamol (Calpol) in line with the manufacturers instructions. Children over the age of 12 years or adults can use Soluble Aspirin gargles (2 tablets four times daily) as an alternative to the Paracetamol. Do not worry if children do not take solid food for a few days. This will do them no harm at all provided they drink plenty of fluids; water, diluted fruit juice etc. If, on looking at your throat, you see that the tonsils are covered in white spots or yellow material, then consult your doctor within the next 24 hours. If in general your sore throat is not settling or showing signs of beginning to settle within about 5 days, again consult your doctor.
Sprains. Many of these are picked up in a sporting context. As soon as possible after the injury happens apply an ice pack for 10-15 minutes. This will drastically cut down the amount of swelling and will speed your recovery. Frozen peas are a good alternative to an ice pack. After this a tubigrip or crepe bandage can be applied to keep up the pressure on the affected area. Providing you are able to take them and that you are over 12 years of age, a simple anti-inflammatory such as Nurofen should be taken for 3-5 days. Again, this will also speedup the healing process.
Vomiting. Vomiting is an extremely common complication to many illnesses, especially in children. Initial management is centered around trying to replace the lost fluids. Therefore, initially, given plenty of clear fluids. A small amount on a regular basis is the best way to do this. The vast majority of vomiting bugs settle down within 24-36 hours. Providing you are taking small amounts of fluid during this you will come to no harm. It is important when vomiting to avoid milk and dairy based products, as these are hard to digest and will probably lead to further vomiting. Milk or solid food should not be re-introduced until about 8-12 hours after the vomiting has stopped. Clear soups and pasta are a useful adjunct to fluids when the vomiting is beginning to settle.
THE FAMILY MEDICINE CHEST
Here is a list of useful medicine and dressings with a description of their uses. All are quite cheap and worth stocking at home in readiness for minor illness. Keep them in a box or cupboard with a lock – or store them well out of the reach of children.
Soluble Aspirin Tablets. For adults and older children. Good for headaches, colds, sore throats and painful bruises.
Paracetamol Mixture. For relief of pain or fever in young children.
Menthol Crytstals or Vick or Friars Balsam. Add to hot water to make steam inhalation for treating catarrh and dry or painful coughs.
Antiseptic Solution. For treating septic spots, sores in the nose and grazes.
Calamine Lotion. For dabbing (not rubbing) on insect bites and strings and sunburn.
Dressing Strips. For Minor cuts.
3” Wide Crepe Bandage. Keeps dressings in place, supports sprained or bruised joints.
Cotton Wool. For cleaning cuts and grazes.
Thermometer. Useful to confirm fevers.
Tweezers. For removing splints.
Remember that your local chemist can give advice about medicine.