Headaches and Fever

Headaches have many causes. Often they can develop for no apparent reason as a symptom of common illness such as flu. Sometimes they are an indicator of a more serious condition such as a head injury, stroke, or other serious illness.

TREATMENT

1. Settle the person into a comfortable position in a quiet place. Consider remedies such as dimming the lights, applying a cold compress, providing fresh air, and encouraging sips of cold water.
2. Check for other signs and symptoms that may indicate a more serious condition and take action as appropriate. Seek urgent medical advice if:

• There has been a head injury
• There are signs and symptoms of meningitis.
• The person appears confused, drowsy, or there is any fall in the level of consciousness

     3. Help the person to take her usual painkillers.

     4. If the pain persists, seek medical advice.

SIGNS AND SYMPTOMS OF MENINGITIS

Any combination of the following may be present:

• Fever
• Headache
• Nausea or vomiting
• Stiff neck (pain or difficulty in touching the chest with the chin)
• Convulsions
• Sensitivity to light
• Rash (bleeding under the skin) which does not go away if a glass is pressed against it

In addition, in babies and young children:

• The soft spot on the head (the fonatanelle) may be stretched tight
• There may be floppiness, lack of focus on surroundings.

FEVER

A person's normal temperature is between 96.8-100.4 F. A fever occurs when the temperature remains higher than this for some time. Most fevers are caused by infection, either infection associated with diseases such as flu, meningitis, or chickenpox, or with a local infection, such as may follow a bite or an open wound. Most fevers pass with minimal risk but a temperature over 104 F can indicate a serious infection and medical advice should be sought. High temperatures, particularly in young children, can cause febrile convulsions.

TAKING A TEMPERATURE

A raised temperature is a sign that the body is fighting off an infection. There are several types of thermometer that can measure the body's temperature. One of the most accurate is a mercury thermometer, in which a narrow column of mercury expands in response to heat and moves up to a point on a clearly marked scale. Take a temperature on the forehead, in the mouth, under the arm or, if you have an appropriate thermometer, in the ear. Do not take child's mouth temperature if you are using a mercury thermometer-- she may bite it and swallow mercury, which is poison.

TREATMENT

1. Make the person comfortable. Ensure that the surrounding air is cool (open a window or use a fan) and provide cool washcloths or sponges. Take care not to overcool.
2. Give the person plenty of cool drinks. Encourage the person to sip these slowly to prevent feeling nauseous.
3. Look for any other signs of infection, such as rashes or swollen glands, and seek medical advice if you are unsure of the cause or seriousness of the condition.
4. Enable the person to take her usual analgesics. Acetaminophen acts as an antipyretic, which means that it will help reduce a fever as well as bring pain relief. Non-steroidal anti-inflammatories (NSAIDS) such as ibuprofen are good for bringing down fever. Children should take medicine appropriate for their age.

SIGNS AND SYMPTOMS OF FEVER

• Raised temperature
• Pale skin (becoming red as the temperature rises)
• Feeling shaky and shivery
• Increasing aches, pain, and headache as the temperature rises

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Insect Bites and Stings

Insect bites and stings are painful and there are many insects native to the US that carry potentially fatal venom. Dangerous biting  insects include spiders such as the black widow, brown recluse, and some tarantulas; stinging insects include scorpions, wasps, and bees. Children and the elderly are most at risk but even so, stings and insect bites rarely kill unless there is an allergic reaction. Stings in the mouth or throat are also dangerous because the swelling they cause can block the airway. In all cases, avoidance is the best defense.

STINGS AND BITES. A sting is felt as a sudden sharp pain and appears as a raised white patch on a reddened area of skin. A bite is less painful and usually causes mind discomfort and skin inflammation.

POTENTIALLY LIFE-THREATENING RESPONSE TO STINGS AND BITES
Anaphylaxis
This is an  allergic reaction to a substance with which the body is in contact (see Anaphylactic shock). Bee stings are among the most common cause. Anaphylaxis can develop within seconds and can be fatal.

Multiple stings
While one sting is unlikely to cause problems on a major scale for an otherwise healthy adult, several stings may provoke a dangerous response.

Effects of Venom
Some venoms kill the cells around the bite or sting mark, are slow to heal, and leave deep scars. In rare cases, they can be fatal. Other venoms affect the nervous system and require an anti-venom medicine or they may be fatal.

SIGNS AND SYMPTOMS OF A LIFE-THREATENING REACTION

• Difficulty breathing
• Swollen lips, tongue, and throat
• Blotchy skin
• Victim has felt a bite  or sting (sometimes this may be described as a scratch)
• Pain, swelling, and reddening  over the site of the bite or sting

Treatment

1. Monitor and maintain airway and breathing. Be prepared to resuscitate if necessary.
2. If the victim is a known sufferer of anaphlaxis, he may have an auto-injector that contains life-saving medicine. Help him to find this as quickly as possible and, if necessary, help to administer it.
3. If the victim is conscious, help into the most comfortable position (this will usually be sitting up).
4. If the sting was in the mouth, give the victim an ice cube to suck or frequent sips of cold water.
5. Call 911 and explain what has happened, identifying the insect if possible.
6. Make an attempt to identify what the victim has been bitten or stung by but do not put yourself at risk.

ORDINARY BITES AND STINGS

Treatment

1. If you can see the sting, remove it by flicking with the edge of a piece of plastic such as a credit card, or with tweezers. Take care not to squeeze the poison sac at  the end of the sting.
2. Wash the affected area to reduce the risk of infection entering the wound.
3. Apply a cold compress to the site to reduce pain and swelling.
4. Remove rings, watches, or anything likely to cause a constriction if the area swells.
5. Advise the victim to see a doctor  if pain persists or there are any signs of infection.

SIGNS AND SYMPTOMS

• Reddening, pain, and swelling over the site of the sting
• Person has felt a bite or sting
• Sting left in the skin (if from a bee)

MORE ON BITES AND STINGS

The general guidance for dealing with bites and stings is: to monitor airway and breathing; be prepared to resuscitate if necessary; to support and reassure the injured person; to offer relief with a cold compress; and to avoid infection by cleaning and covering the wound. In addition, there are some specific treatments that may be useful for certain types of bites and stings.

TICKS

Ticks are tiny bloodsucking creatures found in long grass that attach themselves to animals and humans firmly be embedding their mouthparts into the skin. Ticks cause discomfort and can transmit disease. Although simple to remove, great care should be taken because the mouthparts could remain in the skin if removed incorrectly. Use a flat-ended pair of tweezers or gloved fingers and grasp the tick at its head end, as close to the skin as possible. Using even pressure, pull the tick straight up, avoiding twisting and squeezing the tick's body. Once it has been removed, clean and cover the bitten area.

MOSQUITOES

Mosquitoes are small airborne insects. They feed on animals, including humans, by injecting a minute amount of anesthetic and a chemical that stops blood from clotting and then sucking blood from their host until they are full. Unfortunately this can leave a small inflamed area that is uncomfortable but not life-threatening. This can be easily treated by a cold compress.

In many countries mosquitoes carry malaria, which can be fatal. Should you visit countries that have malaria areas, you must seek advice from your doctor on how to protect yourself and which antimalarial drugs are best suited to you.

JELLYFISH

There are a few species of jellyfish that are poisonous. Generally those that are poisonous have long tentacles that sway freely beneath their bodies and contain stingers that inject chemicals into anyone that should come too close. Although not normally fatal, they can cause extreme pain that leads to panic, especially in children, which can lead to further danger in the water. A sting may also cause anaphylactic shock in some people.

These stings can be treated by calming the victim and then applying alcohol or vinegar to the affected area for a minimum of 3 minutes or until the pain subsides.

Should the victim suffer a severe allergic reaction, emergency medical aid should be sought.

TOADFISH

There are many marine creatures that can cause pain and infection if you step on them. Toadfish are found off the US Atlantic and Gulf coasts. They are small fish that bury themselves in the sand, usually in shallows where they hunt. They have sharp spines on their dorsal fin that can inject poison into anyone who steps on them.

Although the pain is extreme, it can be quickly relieved by placing the affected area in a bowl of water as hot as the sufferer can stand for 20 minutes or until the pain subsides. Make sure you test the hot water with your elbow first because otherwise you may scald the skin.

If the victim suffers a severe reaction, emergency medical aid should be sought.

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Animal Bites

There is a risk of infection with any animal bite, no matter how small. The bite should be assessed by a doctor as soon as possible to see if a tetanus or rabies injection, or a course of antibiotics, is require. First aid treatment for bites is to keep the wound clean and control any bleeding.

ANIMAL BITES. Any animal bite requires medical attention. Deep bites can cause serious wounds, severe bleeding, and tissue damage, while all animal bites can cause infection. Puncture wounds from teeth carry infection deep into the tissue, while scratches are also an infection risk. The human bite is among the most infectious.

CHECKING FOR INFECTION
Warn the injured person to watch for signs of an infected wound over the coming days. Seek immediate medical attention if any combination of the following signs and symptoms develops:

• Increased pain
• Swelling
•  Redness around the site of the wound
• Discharge from the site
• Unpleasant smell from the site of the wound
• Red tracks from the site of the wound to the heart
• Swollen glands

TREATMENT

The priority is to ensure the safety of yourself and bystanders. If the animal is still a risk, do not approach it but call the local Animal Control Service through your police department.

For serious wounds

1. Help the injured person sit down to help reduce shock.
2. Treat any bleeding by:

• Looking in the wound
• Applying direct pressure
• Elevating the site if it is a limb

     3. Take or send the person to hospital.

For smaller wounds and scratches

1. Wash the wound thoroughly with soap and water.
2. Dry the wound with clean gauze or other non-fluffy material and cover with a  dressing.
3. Seek medical advice.

SPECIFIC INFECTIONS SPREAD BY BITES

Rabies

Rabies is an increasingly rare but potentially very serious, even fatal, condition carried by animal bites. Rabies in the US is rare, but if the bite is from an animal that may have come into the country without going through normal checks, or if you are bitten overseas, then seek immediate medical attention. There is no cure for rabies but early vaccination following bite can help develop immunity.

Hepatitis B and C

There is a small chance that hepatitis B and C may be transmitted by a human bite. If concerned, seek medical advice.

Tetanus

Tetanus bacteria carry a particular risk when carried deep into a wound with jagged edges or a puncture wound. Animal bites carry a potential risk of tetanus. Tetanus affects the central nervous system and can cause muscle spasms, breathing problems, and sometimes death. It is also known as lockjaw because it may tense up the jaw muscles. There is a vaccination for tetanus but immunity is not lifelong and anybody suffering a potentially hazardous injury should seek medical advice on having a booster injection.

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Foreign Bodies

Children are prone to putting objects into their nose, ears, and mouth. If left for some time, such objects can cause infection that may result in permanent damage. Young children are also liable to swallow small objects. These usually pass through the system and can be identified in the bowel movement as having safely moved through the body. Larger or sharp objects pose a greater risk of internal injury. If there are signs of difficulty breathing, the object may have gone down the windpipe rather than the tube to the stomach (esophagus). Call 911 and follow the procedures for choking.

FOREIGN BODIES IN THE EAR
Treatment
Do not attempt to remove an object from the ear-- you are likely to push it further, causing more damage, particularly to the eardrum. Reassure the child and take her to hospital.

SIGNS AND SYMPTOMS OF A FOREIGN BODY IN THE EAR

• Pain
• Temporary deafness
• Discharge

SIGNS AND SYMPTOMS OF AN INSECT IN THE EAR

• Very loud buzzing/ringing noise in the ear
• Pain or discomfort

INSECT IN THE EAR

Treatment

1. Sit the child down and reassure him before giving treatment.
2. Lean the child's head toward the unaffected side and pour tepid water into the ear with the aim of floating the insect out.
3. If this does not work, take the child to hospital as soon as possible.

FOREIGN BODIES IN THE NOSE. The key priority with any object in the nose is the maintenance of a clear airway. If any time the object appears to be making breathing difficult, follow the procedures for choking and make a call for emergency assistance.

Treatment

1. Sit the child down, and reassure him.
2. Encourage the child to breathe through his mouth rather than his nose.
3. Do not attempt to remove the object as you may push it further in, causing more damage.
4. Take the child to the hospital so that the object can be removed.

SIGNS AND SYMPTOMS OF A FOREIGN BODY IN THE NOSE

• Pain
• Swelling
• Discharge (if the object has been there for some time)
• Breathing difficulties
• A snoring sound on breathing

FOREIGN BODIES IN THE EYE. Small items stuck to the white of the eye can be very irritating but are usually easy to remove. If an item is embedded in the eye or is stuck on the colored part of the eye (the iris), do not attempt to remove it. Cover the eye as appropriate and take the person to hospital for treatment.

Treatment

1. Sit the person down facing the light so that you can clearly see what needs to be removed
2. Examine the eye by gently separating the eyelids with your finger  and thumb. Ask the person to move the eye up and down and from left to right. Allow the person to blink.
3. If you can see the foreign body and it is not embedded or touching the colored part of the eye, gently wash it out. Tilt the head to one side and run water through the eye, holding the eyelid open. Continue with this treatment for up to 30 minutes, allowing the person to blink regularly.
4. If washing does not work and the object is not embedded in the eye, try to remove the object, take the person to hospital.

SIGNS AND SYMPTOMS OF A FOREIGN BODY IN THE EYE

• Irritation and/or pain
• Watering and/or red eye
• Blurred vision

SWALLOWED OBJECTS

Treatment

If the object was very large, sharp, or potentially poisonous (for example, some kinds of battery), call 911. If the object was small and smooth, take the child to a doctor or hospital as soon as possible.

SIGNS AND SYMPTOMS OF A SWALLOWED OBJECT

• Ask the child or bystanders what happened, and look for other small objects around the child
• Stomach pain

INHALED OBJECTS. It is possible for small and smooth objects to be inhaled into the lungs. This may cause difficulty breathing particularly if the objects are porous and swell up on contact with body fluids. Small nuts are a particular risk, with the added concern that some people have a severe allergic reaction to them.

Treatment

1. If the person is unable to take a breath, treat her for choking if necessary and perform the Heimlich Maneuver to displace the obstruction.
2. Call 911 as soon as possible and monitor breathing while waiting.
3. Reassure the person and try to find out exactly what was inhaled.

SIGNS AND SYMPTOMS OF AN INHALED OBJECT

• Choking noises which pass as the object moves into the lung
• Hacking cough
• Difficulty breathing
• Ask bystanders what happened and look around for evidence of bags of nuts, sweets, etc.

By: Unknown On 9:09 AM

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Dealing with Splinters and Fish Hooks and Infected Wounds

Large objects embedded in a wound, or foreign objects near to a vulnerable site such as the eye, need special care and medical treatment. Smaller debris, such as shards of glass or splinters of wood, stuck into minor wounds can usually be successfully managed at home without further treatment.

REMOVING SPLINTERS

1. If the splinter is fully embedded in the skin, clean the wound, cover gently, and seek medical attention. If part of the splinter is out of the skin, you may try to remove it with tweezers.
2. Pass the tweezers over a flame to clean them and reduce the risk of infection.
3. Use the tweezers to grasp the end of the object and to gently pull it out at the same angle that went in. If the splinter breaks off in the wound or is not easy to remove, treat it as you would a larger foreign body.
4. Once removed, squeeze the wound to express a small amount of blood, clean the site with soap and water, and gently cover with a plaster or dressing as appropriate.
5. Splinters can carry infection into the body so check the site for any signs of infection over the coming days. Tetanus is a particular risk, especially if the splinter was obtained while gardening, so check the date of the person's last tetanus immunization and seek a booster if necessary.

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FISH HOOKS. While the injuries associated with an embedded fish hook may be relatively minor, they are particularly difficult to remove because of their barbed ends. Only try to remove one if medical help is not readily available, for example, if you are on a boat.

WHEN MEDICAL HELP IS EASY TO ACCESS

1. Cut the line as close to the hook as possible to prevent it catching on something and causing further damage.
2. Pad around the hook until you can bandage over or around it without pushing it further in.
3. Seek medical help to ensure there is no underlying damage to the tissues.

WHEN MEDICAL HELP MAY TAKE SOME TIME TO ARRIVE

If you can see the barb:

1. Cut the line as close to the hook as possible.
2. Cut the barb away and carefully remove the hook by its eye.
3. Clean and cover the wound and elevate if it is on a limb.
4. Check the wound for signs of infection over the coming days and check that the person's tetanus booster is up-to-date.

If you cannot see the barb:

1. If you are able, push the hook quickly and firmly forward through the skin until the barb can be seen.
2. Cut the barb away and then treat as outlined above.

If the barb cannot be easily removed, do not attempt to remove the hook-- instead, treat as for a larger embedded object.

TREATING A LARGER EMBEDDED OBJECT

• Do not attempt to remove the object.
• Apply pressure to the wound by padding around the base of the object over the top of sterile gauze or a piece of clean material.
• Bandage over the padding to apply pressure without moving the object.
• If the object is embedded in an arm or leg, elevation may help to reduce bleeding and pain.
• Seek medical help.

If the object is very long, provide additional support at its base to prevent it from moving.

INFECTED WOUNDS

Any injury that pierce the skin can become infected. Infection is caused by germs entering the body, either through the object causing the injury (for example, a dirty knife) or from sources after the injury occurred. Cuts, burns, bites, stings, and open fractures all carry with them a risk of infection.

PREVENTING INFECTION. There are a number of things that you can do to reduce the risk of infection.

• When time permits (for example, for non-life-threatening, less serious injuries), wash your hands thoroughly before treating an open wound.
• Wear gloves if available.
• Try to reduce direct contact with the open wound-- for example, ask the injured person to apply pressure with her own hand if possible.
• Cover injuries as soon as practicable.
• Do not cough over injuries-- turn away and cover your mouth. Advise the injured person to check that her tetanus immunization is up-to-date.

1. Wash your hands thoroughly under running water before treating an open wound if you have time to do so. This will reduce the risk of transmitting germs into the wound.
2. A disposable rubber glove is an ideal barrier method to prevent contamination of a wound. Keep a pair in the top of your first aid kit to reduce direct contact with the wound.
3. Ask the person who has been injured to apply pressure with her own hand if possible to reduce direct contact with an open wound and lessen the risk of infection.

SIGNS AND SYMPTOMS OF INFECTION

If the following signs and symptoms develop after an open wounds is inflicted, the injured person should seek immediate medical attention:

• Increased pain
• Swelling
• Redness around the site of the wound
• Discharge from the site
• Unpleasant smell from the site of the wound
• Red tracks from the site to the heart
• Swollen glands
• Failure to heal

TREATING AN INFECTED WOUND

1. Cover the wound with a sterile dressing and bandage into place.
2. Raise the injured part if possible, to reduce swelling and pain.
3. Seek early medical advice. Treat for shock if necessary.

By: Unknown On 9:08 PM

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