Dulwich Medical Centre: Self Treatment

Please note – The information set out below gives a guidance for dealing with common conditions. If you are in any doubt, particularly with regard to your child’s health, please contact your GP or NHS Direct (click here).

Many conditions get better on their own and can be treated successfully at home. Your pharmacist may be able to help you with these and advise about medicines you can buy over the counter

Colds and flus
These usually start with a runny nose, cough, temperature and aches. They are caused by viruses and antibiotics are of no use in their treatment. Treatment consists of taking recommended doses of paracetamol for the temperature and aches and drinking plenty of fluids.

Diarrhoea and Vomiting
In adults and older children, diarrhoea and vomiting will usually get better on its own. Treatment consists of replacing the fluid that you have lost and resting the digestive system by having nothing solid to eat for 24 hours. Sachets of powder such as Dioralyte and Rehidrat, which can be made into a drink, are available from your chemist. If your diarrhoea contains blood or there is severe pain or high fever, you should discuss it with your doctor. Diarrhoea and vomiting in small babies and young children should be treated with caution and the doctor will be happy to advise you about this over the phone and arrange to see you if necessary.

Backache, Strains and sprains
Many acute strains and sprains will respond to a few days gentle mobilisation (moving around as normal but avoiding bending, lifting, twisting) if the symptoms continue you should consult the doctor. You may wish to see the chiropractor

Headlice
These creatures prefer clean hair and are not a sign of poor hygiene. Insecticide lotions can be obtained from the chemist without prescription. Treatment is only required if live moving lice are found on combing. After treatment hair should be wet combed five days after treatment and if live lice found a second application of insecticide notions will be required.

Small burns
If you burn yourself, you must immerse the affected area under cold running water immediately for several minutes. This helps to reduce pain and tissue damage. Please come in and see the nurse if you are concerned.

Insect bites and stings
Most of these need no treatment. Anti-histamine tablets can be obtained from the chemist without prescription and will relieve most symptoms.

Nose bleeds
Sit in a chair (leaning forwards with your mouth open) and pinch your nose just below the bone for about ten minutes by which time the bleeding usually stops. If the bleeding continues, consult your doctor

Chicken Pox
On the first day a rash appears with small red spots 3 or 4mm wide. Within a few hours these develop into small blisters at the centre. During the next three or four days further spots will appear and the earlier ones will turn crusty and fall off. Calamine lotion may be applied to help the itching. Cool baths may also help. The most infectious period is two or three days before the rash appears and until the last crusts have formed dry centres. Patients must stay at home for a minimum of 6 days from the onset of the rash. Children may return to school as soon as the last ‘crusts’ have dropped off

German Measles
The rash appears during the first day of the illness and usually covers the body, arms and legs in small pink spots about 2-4mm large and does not itch. There are usually no other symptoms, apart from occasional aching joints. It is infectious from two days before the rash appears until the rash disappears in about four days. The only danger is to unborn babies and it is important to avoid people who are pregnant. Immunisations can prevent this disease.

Measles
The rash is blotchy and red and appears on the face and body, on about the fourth day of feeling unwell and is often accompanied by a cough. It is most infectious from two or three days before the rash appears until seven days afterwards. Immunisations can prevent this disease.

This is a rare illness that is most common in babies, children under four years and teenagers, and requires urgent attention. It is important to be aware of the symptoms which we have listed below.

* Difficulty waking
* A high pitched cry that is different from a normal cry
* Repeated vomiting
* Refusing feeds
* Pale or blotchy skin, especially with red or blue/black bruises that don’t go white when you press on them
* Tight or bulging soft spot on the top of your baby's head

Signs and symptoms in OLDER CHILDREN and ADULTS are:

* A high temperature
* A constant headache
* Vomiting * Drowsiness or confusion
* Dislike of bright lights
* Stiffness of the neck (moving their chin to the chest will be particularly painful)
* A rash of red/blue spots or bruises that don’t go white when pressed with a tumbler

If you are in any doubt contact your doctor immediately.

Mumps
The symptoms are swelling of the salivary gland in front of one ear often followed a couple of days later by swelling in front of the other ear. It is infectious for two or three days before the swelling starts until the swelling has subsided. Immunisations can prevent this disease.

A Temperature
A temperature occurs commonly even with mild infections, and is usually in itself not at all dangerous. In small children it is important to stop the temperature rising too quickly and children should be given paracetamol syrup, which may be bought from the chemist. If they still appear hot, they should be gently sponged with tepid water in order to cool them. A child with a temperature will not come to any harm being wrapped up and brought by car or by pram to the surgery

A child will develop a fever because of an infection. Usually the child will get over such an infection without the need for antibiotics. Most childhood infections are caused by viruses and these do not respond to antibiotics. The following advice will help to bring your child's temperature down and make them feel better.

1. Always keep a supply of paracetamol syrup (Calpol, Disprol) at home. If you wait until you need it, there will be none close at hand.

2. If your child feels hot or appears unwell -

a) Give the maximum dose of paracetamol stated for a child of that age.

b) Dress your child in cool clothes. A lot of heat is lost through a child's head, so leave it uncovered. Cool down the room by opening doors and windows.

c) Give your child plenty of cool drinks as fluid is lost with a fever. If they are reluctant to drink, encourage small amounts from a favourite cup.

d) Sponging your child down with a tepid flannel will make them feel better as well as bringing their temperature down. Using tepid water is more effective than using cold water.

e) Repeat the dose of paracetamol every four hours as necessary, up to the maximum daily dose stated.

f) A child with a fever is likely to be restless at night. Offer cool drinks and sponge them down if they wake.

g) If your child does not improve after giving paracetamol and sponging, or appears particularly ill, call the doctor.

3. Very rarely, a child under five years will have a convulsion with a high temperature. They will shake all over and become very still. It usually subsides in less than five minutes. Lie the child on their side and stay with them while it lasts. If there is another adult in the house, ask them to phone 999. If not, call when the convulsion has passed. (If the convulsion lasts for more than 5 minutes then it is advisable to call 999 even if you are on your own.)

DO NOT MOVE THE PATIENT IF
* You think there may be a back or neck injury or any other injury that could be made worse by movement
* The person is in shock
* The person has breathing problems
* The person has severe chest pains

IF THE PATIENT IS NOT SERIOUSLY ILL OR INJURED
* Take the patient directly to the accident department of the nearest hospital

WHEN TO SEEK URGENT MEDICAL ATTENTION
* Head injuries
* Loss of consciousness
* Severe bleeding, chest or stomach pains
* Broken or dislocated bones
* Choking

RECOVERY POSITION
If the patient is unconscious but breathing
* Turn them on their side
* Check airway is open by lifting their chin and tilting the head back slightly

HOW TO RECOGNISE SEVERE CHEST PAIN OR A HEART ATTACK
* Vice-like pain in the middle of the chest, often spreading down the left arm and jaw
* Shortness of breath
* Sudden faintness or giddiness
* Grey pallor to the skin
* Lips look blue

HOW TO RECOGNISE MEDICAL SHOCK
* Patient becomes pale, sweaty, drowsy and confused

IF CONSCIOUS
* Seek urgent medical help
* Reassure the patient
* Do not give anything to eat or drink

BURNS
Apply large quantities of cold water to the affected area as soon as possible and maintain this until the pain subsides. This may take as long as 15 minutes! If the skin is unbroken but blistered, apply a loose, dry dressing.
If the burn is larger than four or five inches in diameter or if the skin is broken, consult your doctor as soon as possible.

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For information on specific vaccinations relating to your travel destination, please click here http://www.fitfortravel.com/en/default.asp

It is always a wise precaution to pack some essential items in case of illnesss on holiday.
Do choose medicines according to your needs and the country you are visiting.
If you take prescription medicines regularly remember to pack then too.

HOLIDAY KIT
* Paracetamol
* Travel sickness tablets
* Plasters
* Rehydration solutions such as Dioralyte
* Anti-diarrhoeal, eg Imodium
* High factor sunscreen; calamine lotion

Immunisations
* Always check whether you need any Immunisations or malarial tablets before you travel (click here for link to travel vaccinsations guide http://www.fitfortravel.com/en/default.asp

* Seek advice well in advance in case you need a course of injections (click here see services provided by Practice Nurse – link to nurse service page)

OTHER ESSENTIALS TO PACK
* Anti-malarials
* Water purification tablets
* Insect repellent
* Condoms/ other contraceptives

MEDICAL INSURANCE
* Arrange medical insurance
* Obtain a form E111 from the Post Office if you are travelling in Europe. This will entitle you to free or reduced cost medical care within the EU. Take the form with you on holiday. (Care can still be very expensive even with an E111 form.)

A healthy lifestyle can help you reduce the risk of getting seriously ill. You will feel better and it will help improve your immune system.

In small quantities, alcohol can actually be beneficial to health. In large quantities, on a regular basis, it can have a very serious negative effect on health. At one extreme it can kill. CIRRHOSIS of the liver, for instance, is killing an increasing number of people, as are drivers who are over the limit.

* An accepted safe limit is 28 units a week for men and 21 units for women, a unit being approximately a glass of wine, half a pint of beer or a single measure of spirit
* This recommended maximum presumes that the consumption is spread throughout the week and not consumed all at once in a ‘binge’

* Over 100,000 people die each year in the UK from smoking-related diseases
* Every cigarette you smoke can shorten your life by an average of five and a half minutes
* Babies of smokers are, on average, 200 grammes smaller than those of non smokers
* Smokers smell!

Stopping smoking is all about motivation. Without the real desire to give up you are unable to succeed. You must want to give up rather than feel you should give up.
* Set a date a week or so in the future when you intend to stop
* Tell all your friends, relations and work colleagues that you’re giving up on that day and ask for their support and encouragement. If at all possible, find someone to give up with you
* When the big day comes, plan it carefully with plenty to keep you occupied. Avoid situations where the desire to smoke will be strongest such as whilst drinking
* Finally, carefully put the money you would have spent on cigarettes on one side, each day, to save up for some special treat as a reward
If you’ve tried everything and failed but are still keen to give up, seek help from your doctor.

· Advice and information on quitting smoking - www.givingupsmoking.co.uk
· Action on smoking and health - www.ash.org.uk
· Online community for quitting smokers by quitting smokers -
www.quitsmokinguk.com

If your diet is lacking, your body has ways of letting you know, for example, you may be overweight or underweight or you may have a spotty complexion or constipation. Ultimately, a bad diet can lead to serious problems such as heart disease.
* A good diet helps fight off disease and makes you look and feel good

Please discuss your weight with the GP. Chances are you weigh more than you should.

Regular exercise has both physical and mental benefits.

Tension and anxiety can be helped by a psychologist or counsellor.

Has yours been checked in the past five years?

We recommend women should have regular three yearly cervical smears.

We will check if you are immune and bring your cover up to date

Here is a list of useful medicines and dressings with a description of their uses. All are quite cheap and worth stocking at home in readiness for minor illnesses.

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.

Sedative Cough Linctus
For dry or painful coughs - but not coughs caused by common colds.

Menthol Crystals
Add to hot water to make steam inhalations for treating catarrh and dry or painful coughs.

Vapour Rub
Again, for steam inhalations. Also useful for children with stuffy noses or dry coughs. Rub on the chest and nose.

Ephedrine Nose Drops
For runny noses in children over one year old. Use before meals and at night but not for more than four days.

Antiseptic Solution
One teaspoon diluted in warm water for cleaning cuts and grazes.

3" Wide Crepe Bandage
To keep dressings in place. To support sprained or bruised joints.