Minor ailments and first aid formalities

minor ailments is a topic which need to be learnt by not only health team members but also by everybody and anybody in order to save a life by providing a proper information and knowledge on all first aid techniques.

1. INTRODUCTION Community health nurse is responsible to provide primary health care in the community Treatment of minor ailments and emergencies is an important component of community health nursing Nurse should be able to identify the signs and symptoms of a patient and treat them according to the standing orders Minor ailments indicate slight illnesses and emergencies of smaller nature.

2. PRINCIPLES OF MANAGING MINOR AILMENTS ENSURE SAFE AND HEALTHFUL ENVIRONMENT TO THE PATIENT TREAT THE RISK / INJURED PERSON PROMPTLY TO PREVENT ANY POSSIBLE COMPLICATION IN CASE OF INFECTIOUS DISEASE, TAKE APPROPRIATE PRECAUTIONS TO PREVENT THE SPREAD OF INFECTION KEEP CONTINOUS WATCH OVER THE PATIENTS AND VITAL SIGNS DURING THE PERIOD OF CARE HELP THE PATIENT TO GET WELL SOON AS POSSIBLE AND IN HIS ADL

3. USE THE OPPORTUNITIES OF HEALTH EDUCATION DURING THE CARE ALWAYS REMEMBER THE LIMITATIONS IN PROVIDING THE TREATMENT OR FOLLOW THE PHYSICIANS INSTRUCTIONS HELP THE FAMILY MEMEBERS IN COPING WITH THE SITUATION AND PREPARE THEM FOR TAKING CARE OF PATIENTS AT HOME RESPECT THE BELIEFS OF PATIENT IN CASE OF SERIOUS CONDITIONS REFER THE PATIENT WITH OUT ANY DELAY

4. CLASSIFICATION OF MINOR AILMENTS Minor ailments can be classified into two 1. GENERAL MINOR AILMENTS :- it include common accidents and emergencies which need immediate first aid In this category – injuries and falls , dog bite , burns ,high fever , heat stroke , diarrhea , fainting etc

5. Systemic minor ailments E Y E E AR EYE ACCIDENTS FOREIGN BODIES INFECTIONS POOR EYE SIGHT DRY EYES NIGHT BLINDNESS EAR ACHGE FOREIGN BODY OTTITS MEDIA DISCHARGE DEAFNESS

6. RESPIRATORY TRACT C V S ALLERGIC RHINITIS COMMON COLD SINUSITIS SORE THROAT COUGH DYSPONEA CHEST PAIN ASTHMA HYPERTENSION ANEMIA RHD

7. DIGESTIVE SYSTEM TOOTH ACHE STOMATITIS SORENESS IN MOUTH CONSTIPATION DIARRHOEA INDIGESTION VOMITING ABDOMINAL PAIN INTESTINAL OB S T R U C T I ON HAEMORRHOIDS

8. URINARY SYSTEM NEURO MUSCULAR SYSTEM REPRODUCTIVE SYSTEM BURNING MICTURATION RETENTION OF URINE URINARY INFECTION RENAL STONES HEAD ACHE BACK ACHE CONVULSIONS EPILEPTIC FITS DYSMENORRHOEA HEAVY BLEEDING SORES AND DISCHARGES BREAST LUMP

9. MANAGEMENT OF MINOR AILMENTS ASSESSMENT – Taking history - Performing quick physical examination FINDING THE CAUSE , MAKING THE DIAGNOSIS AND PLANNING FOR CARE PROVIDING TREATMENT AND NURSING CARE EVALUATING THE CARE AND CONDITION OF THE PATIENT – If the outcome is successful , plan for follow up - If condition does not improve or serious signs – refer to hospital

10. STANDING ORDERS Standing orders are directions and orders of specific nature . On the basics of these on the non availability of doctors nurses / health workers can provide treatment at home hospitals or health institutions and community Should be followed in temporary basics / or in emergency situation

11. OBJECTIVES To maintain the continuity of treatment of the patient To protect the life of the patient / to resuscitate him To create the feeling of responsibility in the members of health team

12. US E S Providing treatment during emergency Enhancing the quality and activity of the health services Strengthening of primary health services in the community Decentralization of health responsibilities Developing the feeling of confidence and responsibility in nursing and other health worker Protecting the general public from quacks

13. TYPES OF STANDINGD ORDERS The authorized doctor and the registered community health nurse jointly releases standing orders Institutional Specific Gene r al

14. INSTITUTIONAL STANDING ORDERS Standing order prepared with a view of the available resources , staff position and objectivity of hospital Difference will be there b/w government and private hospitals

15. SPECIFIC STANDING ORDERS Prepared for the trained medical personnel Technical knowledge and special skills are required These orders should compensate the need of a doctor Such orders enhance the quality of CHN

16. General standing orders Common man is expected to follow some SO Eg – in case of diarrhoea – ORS PACKET

17. STANDING ORDERS FOR TREATMENT OF MINOR AILMENTS – FEVER Examine the vital signs Gather information about other symptoms accompanying the fever – head ache , nausea , vomiting , shivering cold running nose , allergy , skin infection , jaundice, fits , cough Provide rest and light meal to the patient Prepare blood slide to examine malaria parasite Give paracetamol tab Give lots of liquids to the patient If the fever is more than 102 deg F – tepid sponge

18. Contd …. Monitor the pattern of fever and wait for two days If the fever is accompanying with rashes- isolate the patient In case of delirium , convulsions , unconsciousness and hyperpyrexia accompanying the fever refer the patient to the hospital

19. HEAT STROKE Person suffering should be kept in shade and in a well ventilated place Note the vitals Remove all clothes from the person and wrap in a wet sheet If the patient is conscious give him cold water mixed salt and other cold drinks Keep continuous observation over temp As soon as refer to hospital

20. DIARRHOEA – GI SYSTEM Monitor the symptoms of dehydration If the dehydration is severe or the patient is in the state of shock – refer him to hospital Provide ORS to the patient Rice water , coconut water , lemon juice , light tea , banana should be given to the patient If there is epidemic of diarrhea sample should be send for stool test If cholera is prevalent immunization should be taken

21. Contd …. Food and water should be protected Notification should be done People should be educated about the control of flies

22. BURNS - SKIN Try to keep the burned body part immersed in water Check the spread of burns If the cloth has stuck to wound – DO NOT TRY TO REMOVE IT Rings , bangles , shoes , belts and other tight fitting articles to be removed Do not touch blisters unnecessarily Assess the percentage of burns Give primary treatment of shock if needed

23. Contd …. Give ORS if patient is conscious and not vomiting Provide analgesics if required Refer patient to further treatment

24. DROWNING - RS Loosen the clothes from chest Make the person lie on his abdomen and get the water out of lungs Resuscitate the patient immediately and send him to the health care centre / hospital

25. BITES - DOGBITE Thoroughly wash the wound with soap and water Use running water Apply Betadine or tincture iodine If the wound is excessive – check hemorrhage Stitches should be done only after 24 hours Give injection TT Do not kill the dog and observe for 10 days Send the patient for ARV therapy

26. SNAKE BITE Make the person lie down Don not allow to move Find out the kind of snake Tie tourniquet above the bite and continue to loosen it every half an hour Make a cut of 1 cm length and ½ cm deep at the place of bite and try to absorb poison from the site ( there should not be any wound in the mouth of the person sucking )

27. CONTD … Clean the place with salt solution / water or ice Console the person and send to hospital

28. SCORPION BITE Remove the sting and put ice on it , after thoroughly cleaning the place Apply tourniquet above the place of bite and remove it after half and hour Give analgesic tablets and also the sweetened milk to drink If patient is in shock – send to hospital

29. FAINTING - CNS Lie down the person .his head should be at a slight lower level than feet If the person is sitting , keep the head bended b/w both the legs Person should get fresh air Once the person gain consciousness ask him to take deep breath and give him liquids to drink If unconsciousness continue refer to hospital

30. INJURIES AND FRACTURES – SKELTAL Clean the wound with soap and water Apply the spirit around the place of wound Apply Betadine solution and bandage the wound with sterile solution Monitor the condition of the patient Treat the patient for shock Immobilize the fractured area Give analgesic and TT

31. WOUND- SKIN Wash the wound with clean boiled water and antiseptic solution Apply spirit around the wound Remove the foreign bodies present in the wound Bandage the wound using Betadine Give injection TT In case the wound is large and need suture , or caused by bullet or weapon refer to hospital

32. Standing orders for MCH CARE Give tablets to check vomiting and nausea in early stages of pregnancy In case of toxemia of pregnancy , advice her restricted salt diet and complete rest Send to hospital if there is edema/ APH / PPH If the mother develop fever after delivery try to ascertain the cause Keep newborn in proper warmth Initiate breast feeding

33. Convulsions in children Lie down the child safely on a bed Loosen the clothes from the chest and let the fresh air come Clean the secretions from his mouth and let the respiratory tract function properly In case of fever give cold sponge Evaluate the cause

34. HEMORR H A GE Lie down the person on back Take BP Press a pad on the site of bleeding Give him liquids Try to find out the cause of bleeding Monitor the state of shock and in case of bleeding or condition of shock getting out of control send the patient for further treatment

35. Unconsciousness Lie down the person in a well ventilated area Remove dentures Clean the secretions from mouth Loosen the clothes from neck , chest and waist Provide artificial respiration in case of blocked breathing Try to find out the reason

36. SORE THROAT - RS Record vitals Inspect for white patches – if yes its s/s of diphtheria – need hospitalization Take throat swab If pharyngities – saline gargle Give aspirin tablets Advice honey syrup with lemon juice and hot water If history of recurrent illness need surgery

37. Cough - RS Find out the duration , type , color and consistency of sputum , weight loss etc If TB is suspected refer to hospital for investigation Advise rest Give aspirin tablets Give steam inhalations

38. INFLAMMED EYES / EYE DISCHARGE Bathe eyes with water and clean with cotton swab Apply sulphacetamide eye drops Demonstrate cleaning and application of eye ointment Cover with sterile eye pad and bandage Refer if vision diminishes Infection that is not responding to treatment or Wounds / injuries

39. EAR ACHE AND DISCHARGE Clean the ears Apply sulphacetamide ear drops Give analgesics , if not coming down refer If discharge is present clean with boric acid and apply ear drops If s/s not subsiding refer

40. TOOTH ACHE - GI If tooth ache with out fever give potassium permanganate solution mouth wash tds If with fever aspirin 5 gms for children and 10 gms for adults Advise dental care Encourge to eat amala , orange , lemon , guava ,, sprouted gram ,tomatoes , raggi and bajra Ask patient to chew a clove with affected teeth

41. CONSTIPATION – GI Advise more fluids . Leafy vegetables Discourage laxatives and purgatives

42. ANEMIA – BLOOD DISORDER Encourage to eat ragi, GLV Advise dry fruits Advise oral iron supplements Get the stool examined for hook worms

43. Bleeding nose Make patient sit with head erect and bend forward Loosen all clothes at neck Ask the patient to pinch nose at the junction of hard and soft palate Don’t let to blow the nose Check vitals Apply cold compress Refer to hospital

44. ROLE OF CHN History collection / assessment Finding out the actions/ complications and any specifications Vitals monitoring Identifying the needs and problems Nursing services under standing orders Implementing referral system Informing authorities – out break of diseases Keeping medicine kit ready Representing nurses view point in meting Being careful about limits Ensure safe and healthy environment