Self Sufficient Health Care

Home Nursing

Relatively few of the illnesses and emergencies which affect people at home or at work need emergency help. What is important, however, is to be quite clear whether or not the problem is serious before deciding to treat it yourself. Check with a good medical reference book or website to see if the course of treatment is clear; if not, have no hesitation in calling the family doctor for more advice, or going to hospital if that appears necessary. For quick reference, all the following entries are arranged alphabetically.

BACK PAIN

Each year, in Britain alone, 13 million working days are lost, and a million and a half people consult their doctors because of back pain. Very little is known about the causes of this very common and often temporarily crippling condition, although as the spine, with its 24 fragile bones and the associated cartilage and tendons is extremely complex, and supports the whole bodyweight, it is not surprising that it sometimes goes wrong.

The most common cause is strain caused by abuse; lifting too heavy weights or abusing the back some other way. Slipped discs can follow, when the rubbery cushion between the vertebrae becomes damaged. General aches and pains in the back become more frequent as we age, sometimes due to an arthritic condition. In women, several gynaecological problems can cause back pain; even a perfectly normal period.

Because some of these conditions can be severe, it is advisable to see the doctor about a painful back if it persists for more than a few days. If, as sometimes happens, your back pain is one of those conditions which can recur, you will have to try to avoid starting it up again.

If you know that over-exertion has caused the problem, be sensible and take things easy. Make sure you sit erect as far as possible, with a cushion supporting the small of the back. A firm bed, or a special orthopaedic mattress can also help considerably. If your mattress is sagging or very soft, put a rigid board beneath it.

Take aspirin, according to the dose specified on the bottle. This is not only a pain-killer, but will also relieve inflammation which is sometimes associated with back pain. Paracetamol is also a useful anti-inflammatory analgesic.

Your doctor may prescribe stronger drugs, heat treatment, or a course of mild exercise. In other cases, a surgical corset may help.

BED SORES

Lying in one position for a long time causes pressure which cuts off the circulation from the parts of the body touching the bed. This eventually causes damage to the tissues, especially in the elderly bedridden, who already have poor circulation. In these pressure points, such as heels, buttocks, hip bones and elbows, the damage eventually causes large ulcers or bed sores. The solution is simple; prevent them by turning the patient as often as possible, without causing too much discomfort. Encourage them to move about in bed, and periodically shift them from side to side. Look out for red patches on the pressure points, and tell the doctor if you see one developing. Bedsores are much easier to prevent than to heal, so keep patients dry and comfortable, and straighten out creases in the sheet which can irritate the skin.

COLDS

Unfortunately no magic cure exists. Don’t bother to try any antibiotics you may have been previously prescribed — they have no effect. Neither does whisky or brandy. Aspirin is about the only remedy which has a worthwhile effect. It will ease the discomfort and reduce the high temperature. Some commercially available decongestants help dry up the runny nose too, but should not be used for more than a few days at a time.

DIARRHOEA

In Britain, diarrhoea in adults and adolescents is usually caused by virus infections, which cannot be treated directly. The symptoms can be eased by the traditional kaolin and morphine mixture or tablets, or by medicines containing codeine.

Holiday diarrhoea, picked up abroad, is quite likely to be caused by bacteria. Take kaolin and morphine and if it does not clear up in few days, consult the doctor.

Diarrhoea in babies needs careful attention. Many babies naturally have loose bowel action up to age six months, due to their liquid diet. But sudden attacks of copious watery diarrhoea mean that the baby probably has an infection. Take it off solids, and give it boiled water with a teaspoon of sugar and half a teaspoon of salt per pint. Consult the doctor if it persists for more than one day, or call him immediately if the baby is vomiting or seems to be weakening.

GASTROENTERITIS

This is a group of diseases in which there is inflammation of the stomach or part of the intestine. Its symptoms are typically vomiting, diarrhoea, and often, pains in the abdomen. The causes can be food poisoning due to bacteria, food allergies, or most commonly, a virus infection, usually called ‘gastric flu’. Diarrhoea and vomiting in infants is also a form of gastroenteritis.

Because the delicate lining of the stomach is likely to be inflamed, most medicines are immediately vomited up (especially aspirin, which irritates the stomach further). A bland medicine like magnesium trisilicate soothes the stomach, and large quantities of water, squashes, or milk should be drunk to replace lost body fluids. Consult the doctor if symptoms persist for more than a day.

Diarrhoea and vomiting in infants under one year is potentially dangerous. Dehydration can develop rapidly. Consult the doctor immediately if diarrhoea and vomiting persist for more than six hours.

STOMACH ACHE

There are seldom any obvious causes for stomach ache, and most attacks are due to either indigestion or wind. A teaspoon of bicarbonate of soda in half a glass of water usually eases indigestion pain, helped by a hot water bottle rested on the stomach. If the pain is caused by wind, it will usually relieve itself quickly. If the pain lasts more than eight hours, seek medical advice. In children it may not be wise to wait this long. Seek medical advice in any case if the pain worsens.

TEMPERATURE

A thermometer is a useful item for the family medical chest, but should be used with discretion. Body temperature varies quite considerably throughout the day, and from person to person. First thing in the morning, the temperature is at its lowest, and rises steadily throughout the day. There is a ‘normal’ temperature however, which falls somewhere between 98.4°F and 98.6°F (36.9°C to 37.0°C).

Generally, a person with an active infection has a raised temperature or fever, caused by the body’s efforts to fight the disease.

Thermometers are not very easy to use, until you have learned the knack of shaking down the mercury before starting to take a temperature.

The scale is marked in divisions of 0.2°F, and has a range of from 94°F to 106°F. Unlike a room thermometer, the silvery thread of mercury will not return to the bulb unless it is shaken down. This is done by holding the stem of the thermometer at the end away from the bulb, and shaking it with a sharp flick of the wrist, until it goes down to the lowest number on the scale.

In adults and adolescents, take the temperature by laying the thermometer under the tongue. In very young children, use the armpit, which can be kept warm by holding the child’s arm firmly down against its side. Keep the thermometer in place for at least two minutes. Don’t attempt to use the rectum to take the temperature; this is a skilled job, to be carried out only by the doctor or nurse.

Shake the mercury down after use, then wash the thermometer thoroughly in cold Use the armpit for taking the temperature of young children.

Soapy water. If you will need it again shortly, stand the thermometer in a jar of diluted disinfectant (but rinse it before using it again).

A temperature 3°F (2°C) above the ‘normal’ range usually means that something is wrong. However, remember that a baby’s temperature can rise sharply when it is crying, or in an older child, during a tantrum. Even in an adult, temperatures can rise markedly during exercise.

Because the temperature varies so much normally, it is not possible to be precise over what is ‘serious’. A temperature of 101°F in a child usually means that they are feeling quite ill, and you should contact the doctor. In an adult, this sort of temperature is not unusual during a severe cold, or more commonly, with influenza.

Except with the elderly, it is not usually necessary to contact the doctor for these illnesses, which usually resolve themselves without treatment.

You can help reduce a raised temperature, by giving aspirin in the maximum dose recommended on the bottle (never exceed this dose). Aspirin effectively reduces temperature. Always give aspirin with plenty of water or some other drink, to avoid stomach irritation. If the patient already has stomach pain, feels queasy, or is vomiting, paracetamol may be given. For children under five years give ‘junior’ or paediatric formulations.

You can also help bring down a high fever by some commonsense measures. This is useful when dealing with young children. Turn down room heating and open windows to cool the air, and avoid bundling up the patient with masses of bedclothes. Bathe the body with tepid water, which will bring a child’s temperature down rapidly. Give plenty of cold drinks.

Contrary to popular belief, uncovering and cooling the patient won’t make their illness worse, but be prepared to wrap them up again as soon as their temperature has dropped.

In a patient whose temperature has already dropped back below normal, it is obviously important to keep them warm, and to give them warm drinks.

A new and convenient method of measuring approxi – mate temperature is a temperature-sensitive strip which changes colour when laid against the forehead.

VOMITING

Vomiting is intended to rid the stomach of anything which is irritating it. While the stomach is still sore, eating anything else will only cause more vomiting. Just drink plenty of water, and wait until the vomiting eases. If it persists for more than a day, contact the doctor for advice. With young children consult the doctor if it persists for six hours.

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