STANDING ORDER.pptx

community health

1. STANDING ORDER FOR TREATMENT OF MINOR AILMENTS While working in health sub-center, primary health center, community health center, hospital or institute, or home or community, many times the community health nurse of other nurses face the situation when it is necessary to provide treatment to the patients e.g. at that time or place where no doctor is available or is likely to come late. In such conditions standing orders come to the rescue of nurse, they help her in providing treatment to the patient.

2. FEVER Examine the vital signs (temperature, pulse, respiration, blood pressure). Gather information about other symptoms accompanying the fever (to ascertain the cause of fever), like headache, uneasiness, nausea, vomiting, shivering, cold, running nose, allergy, skin infection, jaundice, fits, cough etc. Provide rest and light meal to the patient. Prepare blood slide to examine malaria parasite (blood for MP) . Give paracetamol tablet to bring down fever. Give lot of liquids to the patient. If fever is more than 39°C (102.2°F) give cold sponging to patient.

3. HEAT STROKE Person suffering from heat stroke should be kept in the shade and a well-ventilated place. Note the temperature, pulse, respiration and blood pressure. Remove all clothes of the person and wrap him in a wet sheet. Keep him wrapped in the wet sheet till the temperature falls at 38°C. If the patient is conscious, give him cold water mixed salt and other cold drinks. Keep continuous observation over temperature. As soon as there is some improvement in the condition of the patient, refer him to the hospital.

4. DIARRHEA Monitor the symptoms of dehydration. If the dehydration is severe or the patient is in a state of shock, immediately refer him to the hospital . Provide ORS to patient . Rice water, coconut water, lemon juice, light tea, banana, khichadi etc. should be given to the patient. If there is epidemic of vomiting and diarrhea, sample should be sent for stool test. If cholera is prevalent, then people should be immunized against it. Food and water should be protected from getting infected and health officers should be immediately informed (early notification). People should be educated about controlling the files, cleanliness of water and food, and proper disposals of excreta. Give medicines, as per the need.

5. BURNS Try to keep the burnt part of body immersed in water . Check the spreading of burns. If the cloth has got stuck on the burned part, do not try to remove it. though rings, bangles, shoes, belts and other tight fitted articles should be removed. Do not touch the blisters unnecessarily. Cover the burnt part with a clean cloth. Assess the condition of the patient and the percentage of burn. If the patient is in shock, give him primary treatment. Give ORT to the patient (if he is conscious and not vomiting).

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

7. BITES Dog bite Thoroughly wash the wound with soap and water. Use running water. Apply betadine or tincture iodine. If would is extensive, check hemorrhage, but stitches should be done after 24 hours. If available ARS can be used for dressing but serum sensitivity test is essential before use of it. Give injection of tetanus toxoid. Do not kill the dog and observe him for 10 days. Send patient to hospital for ARV therapy.

8. SCORPIAN 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 an hour. Give analgesic tablets and also the sweetened milk to drink. If the patient is in shock, send him to the hospital.

9. FAINTING Lie down the person. His head should be at a slightly lower level than the feet. If the person is sitting, keep his head bended between both the legs. Person should get fresh air. There should not be any crowd around him Once the person gains his consciousness, ask him to take deep breaths and give him liquids to drink. If the unconsciousness continues, send him for further treatment.