50 FIRST AID Sunburn Ultraviolet rays in sunlight can damage cells in the SIGNS & SYMPTOMS outer layer of human skin, causing soreness, redness, and blistering. Skin can burn after just 30 minutes • Very red, hot skin of exposure to the sun and sunburn is most likely to • Soreness occur in the middle of the day, though symptoms may • Swelling not develop immediately. The aims of treatment are • Blistering to move the victim out of the sun, to cool the affected • Possible signs of heatstroke area, and to apply soothing lotions or creams. (p.52) TREATING SUNBURN 1 Move victim inside 3Give fluid Ensure that • If the victim is outside, move him • See that the he takes into the shade or indoors. victim sips small sips plenty of cold of fluid 2Cool burn water while • Get the victim into a cold bath, or you cool apply damp towels or cold water to his skin. the burn for at least 10 minutes. Cool the burned areas 4 Apply lotion • Gently smooth calamine lotion or after-sun cream onto the burned areas. Reapply as necessary. !Important Put cream • If the skin is badly blistered, advise the on burn victim to see a doctor. • If the victim has severe sunburn and heatstroke (p.52), call 911.
SUNBURN • HEAT EXHAUSTION 51 Heat exhaustion Caused by excessive sweating, heat exhaustion SIGNS & SYMPTOMS occurs when vital salt and water are lost through the skin. People who are unused to hot and humid • Feeling dizzy or confused conditions, and those suffering from any illness that • Headache and nausea causes diarrhea and vomiting, are often the most • Sweating, with pallid, susceptible. The aims of first-aid treatment are to cool the victim and to replace lost salts and water. clammy skin Heat exhaustion can develop into heatstroke. • Arm, leg, or abdominal cramps • Fast but weak pulse TREATING HEAT EXHAUSTION 1 Make victim 3Summon help comfortable • If the victim becomes weaker or confused, place him in the • Move the victim to a cool place. recovery position (p.14 for adults • Lay him down and support his and children, p.15 for babies). legs in a raised position to improve • Dial 911 or call EMS. the blood flow to vital organs. 2Replace lost fluids 4 Monitor victim • Give him cool, salty drinks. • Monitor the victim’s breathing Ideally, offer isotonic drinks or (p.68 for an adult, p.71 for a child a weak salt and sugar solution or baby), pulse (p.68 for an adult, (1 teaspoon of salt and 4 teaspoons p.70 for a child or baby), and level of sugar to 1 liter of water). of consciousness (p.12) every • Support his head while he is 10 minutes until help arrives. drinking, if necessary. • If he recovers, ask ! Important him to see a doctor. • If the victim loses consciousness, open his airway, check his breathing, and be prepared Give him to begin resuscitation (pp.12–20). a cool isotonic drink Raise his legs
52 FIRST AID Heatstroke If the human body is exposed to unusually high SIGNS & SYMPTOMS temperatures for a prolonged period, it can become dangerously overheated. The onset of heatstroke can • Headache and dizziness be sudden, and the victim may lose consciousness • Hot, flushed skin within minutes. The aims of first-aid treatment are • Poor level of response to move the victim to a cool place, to reduce his • Rapid pulse temperature, and to get him to a hospital quickly. • Raised body temperature TREATING HEATSTROKE (over 104°F/40°C) 1 Make victim 4 Monitor victim comfortable • Once the victim’s temperature has • Move the victim to fallen to 98.6°F (37°C) under the a cool place. tongue or 97.7°F (36.5°C) beneath • Remove as much the armpit, replace the wet sheet of his clothing (if used) with a dry one. as possible. • Monitor the victim’s condition until medical help arrives. Lay him down • If his temperature rises again, cool in a cool place him down following the same procedure as before. Remove his clothes 2Summon help ! Important • Dial 911 or call EMS. • If the victim loses consciousness, open his airway, check his breathing, and be prepared 3Cool victim to begin resuscitation (pp.12–20). • Drape a cold, wet sheet over the victim. Spray or sprinkle it with Sponge his face water to keep it wet. Alternatively, and body with sponge him with cold or tepid tepid water water, or fan him with cold air. • Keep cooling the victim until his temperature drops to 100°F (38°C) under the tongue or 99°F (37.4°C) beneath the armpit (p.68 for an adult, p.70 for a child or baby).
HEATSTROKE• FAINTING 53 Fainting Pain, fright, fatigue, hunger, emotion, or simply SIGNS & SYMPTOMS standing still for a long period of time have all been known to interrupt the flow of oxygen to the brain, • Feeling dizzy, weak, and which can cause a temporary loss of consciousness, sometimes nauseous or a faint. Your aims are to improve bloodflow to the victim’s brain, to make her comfortable, and • Sweating to treat any injuries that may have occurred when • Very pale skin the victim fell. Recovery is usually rapid. • Low pulse rate • Brief loss of consciousness TREATING FAINTING 1 Raise legs 3Treat any injuries • If the victim has fainted, gently • Look for any injuries that the raise her legs above the level of victim may have sustained when her heart to improve blood flow. she fell after fainting. • If she feels faint but has • Treat these injuries appropriately. not fainted, ask her to lay down, and to raise 4 Help victim up her legs. • When the victim feels better, help • Support her legs with her to sit up very slowly. your body or with a pile • If the victim begins to feel faint of cushions, pillows, again, help her to lay down. or folded blankets. • Raise and support her legs again, until she feels fully recovered. Support legs • Help her to sit up again, moving above level very slowly and making sure that of heart she no longer feels faint. • If in doubt about the victim, 2Make victim call her doctor. See chart p.82 comfortable Feeling faint/passing out. • Loosen any restrictive clothing. • Ensure that the victim gets plenty ! Important of fresh air. If you are indoors, • If the victim does not regain consciousness, open a window or fan her face. open her airway, check her breathing, and be • Keep bystanders away. prepared to begin resuscitation (pp.12–20). • Reassure the victim as she • Dial 911 or call EMS. recovers from the faint.
54 FIRST AID Hypothermia The onset of hypothermia is a reaction to the cold SIGNS & SYMPTOMS and happens when body temperature falls below 95°F (35°C). Hypothermia may develop gradually if the • Shivering victim is in a poorly heated house, or rapidly if the • Cold, pallid skin victim is in freezing weather or immersed in cold • Weak pulse water. Your aims are to warm the victim gradually • Confusion and apathy and to seek medical help if needed. • Extreme fatigue TREATING HYPOTHERMIA 1 Rewarm victim 2Warm victim • Get the victim into a shelter. in bed • Replace any wet clothes with • Put the victim to bed and cover warm, dry clothes and then her well with blankets. wrap her in a survival blanket. • If she is still very cold, help her put on a hat and gloves. • If the victim is indoors, is young • Give her a warm drink to sip. and healthy, and is not lethargic Cover her Help her to or confused, help her into head with sip a warm a warm, but not hot, bath a hat drink and allow her to soak. After a bath, wrap her in warm towels !Important 3Summon help • Do not give the victim alcohol to drink. • If the victim is elderly or a baby, • Do not give the victim a hot-water or if her condition worries you, bottle or place her beside a fire or any call a doctor. other source of heat. • If the victim loses consciousness, open her airway, check her breathing, and be prepared to begin resuscitation (pp.12–20).
HYPOTHERMIA • FROSTBITE 55 Frostbite Frostbite occurs when the body reacts to freezing SIGNS & SYMPTOMS conditions, particularly those accompanied by a high windchill factor, by shutting down blood vessels. As • Sensation of pins a result, extremities, such as fingers and toes, may and needles freeze and if left untreated, could eventually become gangrenous. Hypothermia (p.54) may also occur. • Pale skin becoming The aims of first-aid treatment are to rewarm the numb and hard frostbitten area gradually and to seek medical help. • Skin is white, mottled TREATING FROSTBITE blue, or black 1 Warm frozen part 2Apply dressing • Get the victim to tuck her frozen hands into her armpits, or place • Cover the affected part with a the frostbitten part in your lap, between your hands to warm it. light dressing, wrapping the dressing between frostbitten • Move the victim out of the cold; fingers and toes, and cover the part with a loose gauze bandage. help her if her feet are affected. • Support the part in a raised position • Thaw the frostbitten part in a basin to reduce the chance of swelling. of warm water, then pat it dry. Use your body heat to thaw frostbitten toes ! Important Cover with light • Do not place a source of direct heat dressing and bandage against the frostbitten part. 3Relieve pain • Do not warm the frostbitten part if • As the area thaws, the skin will become hot, red, and painful. it may refreeze. • Give the victim the recommended dose of acetaminophen to help • Do not rub the frostbitten part. ease the pain. • Take the victim to the hospital or arrange for transportation.
56 FIRST AID Swallowed poisons Poisoning can occur as a result of swallowing toxic SIGNS & SYMPTOMS chemicals or poisonous plants, or by overdosing on recreational or medicinal drugs. Seek immediate • Pain in the abdomen or chest medical assistance and provide the emergency • Nausea, vomiting, and services with as much information as possible about the poisoning, including the type of substance that diarrhea was swallowed, the amount, and when. • Breathing difficulties • Dizziness TREATING SWALLOWED POISONS 1 Get information 3Monitor victim • If the victim is conscious, ask her • Monitor the victim’s breathing what poison she has swallowed. (p.68 for an adult, p.71 for a child • Look around her for or baby), pulse (p.68 for an adult, signs of bottles p.70 for a child or baby), and level or containers. of consciousness (p.12) every 10 Ask victim for minutes until help arrives. details of poisoning • Watch for signs of deterioration. • If alcohol poisoning is a possibility, 2Summon help • Dial 911 or call EMS. cover the victim with a blanket. • Tell the dispatcher what you think ! Important the victim • Do not try to induce vomiting. has swallowed. • Some poisons can cause anaphylactic shock. Look for warning signs (p.28). • If the victim loses consciousness, open her airway, check her breathing, and be prepared to begin resuscitation (pp.12–20). • If you need to give rescue breaths to a victim who has swallowed a corrosive poison, protect yourself by using a face shield (see below). Place the shield on the victim’s face, with the filter over her mouth
SWALLOWED POISONS • SNAKE AND SPIDER BITES 57 Snake and spider bites A bite from a venomous snake or spider can cause SIGNS & SYMPTOMS severe pain and burning at the site of the wound, in addition to swelling and discoloration. Most • Severe pain and burning victims of such bites recover rapidly if they receive • Pair of puncture marks prompt hospital treatment and are given the appropriate antivenin. The aims of first-aid (snake bite) treatment are to seek medical assistance quickly and to try to identify the snake or spider. • Nausea and vomiting • Sweating • Breathing difficulties • Irregular heartbeat TREATING SNAKE AND SPIDER BITES 1 Keep victim still 4 Immobilize • Lay the victim down, keeping the injured part heart above the level of the bite. • Place a light compression bandage • Keep the victim calm and still. on the affected part to minimize blood flow. Start bandaging 2Clean wound just above the bite and continue • Wash the wound carefully. up the limb. • Pat it dry with clean swabs or • If a leg is affected, other nonfluffy material, but tie both legs do not rub it. together with folded 3Summon help triangular • Dial 911 or call EMS. bandages. • If possible, give the dispatcher a Bind legs together description of the snake or spider 4 to immobilize that has bitten injured leg the victim. 5Monitor condition ! Important • Monitor the victim’s breathing • Do not catch a venomous spider (p.68 for an adult, p.71 for a child or snake to try to identify it. or baby), pulse (p.68 for an adult, • Do not apply a tourniquet. p.70 for a child or baby), and level • Do not cut the wound open or of consciousness (p.12) every attempt to suck out the venom. 10 minutes until help arrives.
58 FIRST AID Animal and tick bites Any animal bite carries a high risk of transmitting SIGNS & SYMPTOMS infection and should be seen by a doctor. Antibiotics or tetanus immunization may be required. Your aims • Puncture marks (animal) are to stop the bleeding and clean the wound. Treating • Pea-sized body attached a tick bite involves removing the whole tick. to skin (tick) TREATING ANIMAL BITES 1 Make victim safe 3Treat small wound • Remove the victim from any • If the wound is superficial, wash it danger, if possible. with soap and water and pat it dry. Cover with a dressing (p.61). 2Treat severe • Advise the victim to ask his or her wound doctor if immunization is needed. • If the wound is serious, treat as for severe bleeding (p.31). ! Important • Take or send the victim to the • Do not try to capture the animal. hospital for urgent treatment. • Severe infections can be transmitted by animal bites. Seek medical advice in all cases. TREATING TICK BITES 1 Remove tick 3Monitor victim • Using a pair of fine-pointed • Look out for a rash at the site of tweezers, grasp the tick on either the bite and/or flulike symptoms side of its body days after the bite. In either case, (including head send or take the victim to a doctor and mouthparts). in case he or she has developed • Lever out the an infection. Tell the doctor tick with a that the victim was bitten by a tick. rocking motion. ! Important 2Dress wound • Do not apply a hot match, alcohol, or • Wash your hands thoroughly. any other substance to the tick in an • Clean the wound with antiseptic. attempt to remove it. • Cover with an adhesive dressing. • Ensure that you remove both the head and the body of the tick.
ANIMAL AND TICK BITES • INSECT AND SCORPION STINGS 59 Insect and scorpion stings Bee, wasp, and hornet stings are painful but are not SIGNS & SYMPTOMS usually life-threatening. There may be a sharp pain followed by temporary swelling, soreness, and itching. • Stinger stuck in skin Your aims are to watch out for signs of anaphylactic • Swollen red area shock, to remove the stinger, to dress the wound, and • Localized pain to reduce swelling. Scorpion stings can be life- threatening and need urgent medical attention. TREATING STINGS IN THE SKIN 1 Remove sting 2Treat wound • If there is a stinger in the wound, • Wash the injured area with soap gently scrape it off with your and water, and pat dry. fingernail or a credit card. • Cover the wound area with an • Do not grasp the venom sac with adhesive dressing. your fingers or tweezers because • Apply a cold compress on top of pressure on the sac may inject the adhesive dressing to reduce more venom into the victim. pain and swelling. • Advise the victim to seek medical Scrape in the help if symptoms persist. opposite direction to entry ! Important • Dial 911 if the victim has been stung by a scorpion or shows signs of anaphylactic shock (p.28). TREATING STINGS IN THE MOUTH 1 Reduce swelling Soothe sting • In order to reduce swelling, give with water the victim a glass of cold water to sip or ice to suck. 2Summon help • Dial 911 or call EMS.
60 FIRST AID First-aid equipment Having the correct supplies can make a big difference in an emergency, so you should always keep a selection of essential first-aid materials at home and in your car. Store the items in a first-aid box or in a similar type of airtight container in a dry place. The box should be easily accessible in an emergency but kept away from other medicines and out of reach of children. Ideally, the box should be small and light enough for you to carry easily. Check and replenish the first-aid kit regularly so that the contents are kept up to date. HOME FIRST-AID KIT ADHESIVE TRIANGULAR BANDAGES CREPE ROLLER BANDAGES GAUZE ROLLER BANDAGES for use as a sling to for applying pressure to a BANDAGES for covering small wound or to support a cuts and scrapes support and immobilize strain or sprain for holding dressings in an injured limb place on any part of the body Applicator TWEEZERS Bandage for removing splinters GAUZE DRESSINGS WOUND DRESSING TUBULAR BANDAGE SCISSORS light dressings for use sterile dressings that used with a special for cutting dressings combine bandage and applicator to secure directly on wounds and bandages dressing in one dressings on fingers or toes ANTISEPTIC WIPES ANTISEPTIC CREAM MICROPOROUS TAPE SAFETY PINS for cleaning wounds used on cuts and scrapes breathable, low-tack for securing bandages to help prevent infection tape for holding and slings dressings in place CALAMINE LOTION FACE SHIELD DISPOSABLE GLOVES COLD PACK for treating sore and for protection from cross- for protection from cross- for reducing infection when touching swelling in sprains sunburned skin infection when giving and strains rescue breaths body fluids
FIRST-AID EQUIPMENT 61 APPLYING A WOUND DRESSING 1 Apply dressing pad 3Secure bandage • Wash your hands thoroughly and • Tie the ends of the bandage wear disposable gloves, if available. together over the pad. • Choose a dressing with a pad that • Check the circulation (see below) will cover an area 1 in (2.5 cm) and, if necessary, loosen the beyond the edges of the wound. bandage and reapply. • Unroll the bandage until the pad • If blood seeps through, apply is visible, leaving a short “free” another dressing over the top. If it end on one side of the pad and seeps through the second dressing, a roll of bandage on the other. remove both and start again. • Place the dressing pad directly on the wound. Make turns with the main 2Bandage in place bandage • Secure the pad in place by winding the short end of the bandage once Hold the around the dressing and limb. short end • Keep hold of the short end and wind the bandage roll around the dressing and limb. Continue winding the bandage until the pad is completely covered. CHECKING CIRCULATION 1 Apply pressure 2Loosen bandage • Immediately after bandaging a limb, • If the skin color does not return check the circulation in the fingers immediately, the bandage is too or toes beyond the bandage. tight and should be loosened. • Press on a nail or on the skin • Undo a few turns of the bandage. until the area turns pale, then Wait for the color to return to the release the pressure. The color skin, and reapply the bandage more should return immediately. loosely. Check circulation again. 3Monitor casualty • Every 10 minutes, check fingers or toes for signs of poor circulation such as pale, cold skin, or numbness. Loosen the bandage and reapply if necessary.
62 FIRST AID APPLYING A HAND OR FOOT BANDAGE 1 Start at wrist 2Repeat layers • Place the end of the bandage on the • Take the bandage diagonally underside of the wrist at the base across the back of the hand, then of the thumb (or ankle for a foot around the wrist and back over bandage); secure the end by making the hand towards the little finger. a straight turn around the wrist. • Continue, covering two-thirds of the • Bring the bandage diagonally across previous layer with each new turn. the back of the victim’s hand in the direction of the little finger. • When the hand is covered, make • Take the bandage under and across two straight turns around the wrist (or ankle) and secure the bandage. the fingers so that the upper edge touches the index finger about half • Check the circulation in the fingers way up its length. and toes beyond the bandage (see p.61) and loosen it if necessary. Leave fingertips and thumb free Bring bandage diagonally across hand APPLYING A TUBULAR BANDAGE 1 Apply first layer 2Apply second layer • Cut a length of tubular gauze • Push the applicator back over the bandage two-and-a-half times the injured finger, until the finger is length of the injured finger or toe. covered with the rest of the gauze. • Remove the applicator. • Push the gauze on to the applicator, 3Secure bandage and gently place the applicator over • Secure the end of the gauze to the the finger. finger with a piece of adhesive tape, leaving a gap in one place. • Hold the gauze in place at the base • Make sure the bandage is not too tight. If the victim complains of of the finger and pull the applicator pale cold skin, numbness, or an off, leaving a layer of gauze behind. inability to move the finger or toe, remove the bandage and hold the • Hold the applicator just beyond dressing in place by hand. the fingertip and twist it twice.
FIRST-AID EQUIPMENT 63 TYING AN ARM SLING 1 Support arm 3Secure sling • Support the injured arm under • Tie a knot at the hollow over the the forearm or ask the victim to victim’s collarbone on the injured support it with his other arm. side of the body. • Pass one end of the bandage under • Tuck both ends the victim’s elbow on the injured of the bandage limb and pull the bandage across under the knot to the opposite shoulder, so that to act as the longest edge is parallel with padding. his uninjured side. Tie knot over collarbone Longest edge of bandage Support forearm 2Form sling 4 Secure at elbow • Bring the lower half of the bandage • Fold the point of the bandage up over the forearm to meet the forwards at the elbow and tuck other end of the bandage at the any loose bandage underneath it. shoulder on the injured side. • Secure the point of the bandage • Position the to the front of the bandage with forearm so a safety pin, or twist the corner that the hand and tuck it into the sling. is slightly higher than • Check the circulation in the fingers the elbow. after securing the sling, and again every 10 minutes (see p.61). If necessary, remove the sling and straighten the arm. Fold point Use safety forwards pin to secure Leave fingers exposed
2 FAMILY ILLNESS When a family member is ill, turn to the symptoms charts in this section to find out what is wrong. From facial pain to abdominal pain, wheezing to swollen ankles, these charts provide possible reasons for the symptoms and indicate how you can help. How to use this section .66 Coughing (adults).........106 Leg pain .......................145 Coughing (children)......108 Assessing symptoms Joint pain.....................146 (adults) ............................68 Shortness of breath (adults) ..........................110 Swollen ankles.............148 Assessing symptoms (children) .........................70 Breathing problems Erectile dysfunction ....150 (children) .......................112 Not feeling well ............72 Wheezing.....................114 Testes and scrotum Difficulty swallowing...115 problems ......................151 Fever (adults) ..................74 Vomiting (adults)..........116 Vomiting (children).......118 Penis problems ............152 Fever (children) ...............76 Abdominal pain Breast problems ..........154 Excessive sweating ........78 (adults) ..........................120 Menstrual period pain156 Lumps and swellings .....80 Abdominal pain (women) ........................122 Heavy menstrual Feeling faint/ periods .........................157 passing out ....................82 Abdominal pain (children) .......................124 Abnormal vaginal Headache .......................84 Abdominal swelling ....126 bleeding.......................158 Vertigo ...........................86 Anal and rectal Vaginal discharge........160 problems ......................127 Numbness and/ Diarrhea (adults)...........128 Genital irritation or tingling......................88 Diarrhea (children)........130 (women) ........................161 Constipation ................132 Facial pain......................90 Chest pain....................134 Home medicine chest...162 Palpitations..................136 Difficulty speaking ........91 Poor bladder control...137 Caring for a Painful urination .........138 sick person ...................164 Forgetfulness or Back pain .....................140 confusion .......................92 Neck pain or stiffness...142 Arm or hand pain .......144 General skin problems...94 Rash with fever .............96 Eye pain or irritation .....98 Disturbed/impaired vision ............................100 Earache ........................102 Sore throat ..................103 Hoarseness or loss of voice ........................104
66 FAMILY ILLNESS How to use this section This section contains a selection of charts describing symptoms that may cause concern to family members. At the beginning of the section, there is advice on how to assess symptoms of illness, such as how to measure body temperature, take a pulse, and check breathing rates. At the end of the section, there are guidelines for looking after a sick person at home, with suggestions for which medicines to keep in the home and how to administer them. HOW TO USE THE CHARTS Introductory text 84 FAMILY ILLNESS ! Danger signs How is your Dial 911 or call EMS if a vision? This text describes Headache headache is accompanied common causes of the by any of the following Blurred vision relevant symptom. Fever and tension in head and neck muscles are symptoms: common causes of headache. Too much alcohol, • Drowsiness or confusion. Disturbed in Starting point caffeine, or nicotine may also cause headache. Most • Weakness of a limb. other ways headaches do not last for more than a few hours. If • Blurred vision. From the starting point, your headache lasts for more than 24 hours, is not • Dislike of bright light. Unchanged question and arrow improved by over-the-counter analgesics, or recurs • Temporary unconsciousness. pathways guide you several times in a week, consult your doctor. ACTION around the chart. ACTION START Have you hit Do you have CALL YOUR DOCTOR NOW Question box your head a fever – a GO TO ANOTHER CHART You have probably a Fever (adults), p.74, or migraine, particularly Each question is within the past temperature of Fever (children), p.76 if any visual problems followed by two or 24 hours? 100.4°F (38°C) occurred before the more possible answers. headache. However, Choose the one that is Head injury or above? the slight chance of a most applicable. more serious disorder, No head injury Fever such as a stroke, needs Self-help advice to be ruled out if this No fever is your first migraine. This text describes what you can do to treat the Are danger ACTION Have you • Take an analgesic symptom at home and signs present experienced when you should (see box above TRY SELF-HELP MEASURES nausea and/or and sips of water. consult your doctor. right) or have A mild headache is vomiting with you vomited? common following a the headache? • Rest in a darkened, minor head injury. Danger signs Yes quiet room until the present • Take an analgesic pain subsides. No If you have had any Vomited after (not aspirin). previous attacks, try head injury CALL YOUR DOCTOR to identify and avoid IMMEDIATELY potential triggers, such No danger signs if your headache lasts as chocolate. or vomiting for more than 2 hours or if you develop other Does either of ACTION symptoms. the following !DIAL 911 OR CALL EMS ACTION apply? There may be damage to the tissues that TRY SELF-HELP MEASURES The pain is felt surround the brain. Sinusitis is the likely chiefly in the cause of your headache. areas above and below the eyes • Try inhaling steam You have recently from a bowl of hot had a runny or water (p.165). stuffy nose CONSULT YOUR DOCTOR if you feel no better Neither within 2 days. Action panels Possible cause Cross-references The text indicates how This text suggests The charts feature cross- urgently you should see what may have references to other charts a doctor. caused the symptom. containing further information.
HOW TO USE THIS SECTION 67 SPECIAL BOXES ! Danger signs Checking a red rash ! Recurring attacks • Red danger signs and warning Safe alcohol limits of vertigo boxes alert you to situations in One unit of alcohol equals which emergency medical help If you have been experiencing half a pint of beer, a small may save a life. These boxes attacks of vertigo, it is very glass of wine or sherry, or one measure of hard liquor. highlight advice that applies in • The maximum particular medical circumstances. important to avoid certain recommended limit for men is 3 units a day. • Blue information panels tell you activities that are potentially hazardous to you and to • The maximum how to gather the information other people. You should not recommended limit for climb ladders or steep flights you need to answer the questions in the chart. of stairs, operate machinery, ACTION HEADACHE 85 ACTION PANELS CALL YOUR DOCTOR NOW ACTION At the end of every pathway you will find a Acute glaucoma (a possible diagnosis, advice on what to do, and painful, rapid rise MAKE AN APPOINTMENT whether or not you need to seek medical help. in fluid pressure in the TO SEE YOUR DOCTOR There are five possible levels of attention, ranging eye) is a possibility, Your symptoms may from DIAL 911 OR CALL EMS, for the most serious particularly if the pain be side effects of the conditions, to TRY SELF-HELP MEASURES, for minor is around your eye. medication. complaints. It is important to note, however, that even apparently minor complaints should • Stop taking any over- receive medical attention when they occur in the elderly or in people who are undergoing the-counter medicines cancer treatment. but continue to take prescribed medication unless advised to stop by your doctor. Where is the Are you taking pain? any medication? W Medication Over one or No medication both temples Elsewhere ACTION Have you had !DIAL 911 OR CALL EMS CALL YOUR DOCTOR NOW this type of CALL YOUR DOCTOR NOW headache Dial 911 or call EMS for Contact the doctor, day before? the emergency services. or night, by telephone. You may have temporal If there is a delay in Dial 911 or call EMS if you Yes obtaining an ambulance, fail to make contact within arteritis (inflammation go to the hospital by car. 1 hour. No h of blood vessels in the head), particularly if you are over 50 and are not feeling well. SEE YOUR DOCTOR MAKE AN APPOINTMENT WITHIN 24 HOURS TO SEE YOUR DOCTOR ACTION ACTION It is important that the The condition may require symptoms are assessed by medical treatment, but a MAKE AN APPOINTMENT MAKE AN APPOINTMENT a doctor within 24 hours reasonable delay is unlikely TO SEE YOUR DOCTOR of their onset. to lead to problems. if you cannot identify TO SEE YOUR DOCTOR a possible cause for A recurrent headache your headache from for which there is no this chart. obvious cause, such as drinking too much alcohol, should always TRY SELF-HELP MEASURES be investigated fully by your doctor. For minor infections, such as a sore throat or runny nose, use self-help measures, first aid, or over-the- Possible cause not identified counter remedies to relieve discomfort. Always consult your doctor if you are unsure whether a If your symptoms do not suggest a remedy is suitable and read the manufacturer’s diagnosis, the chart recommends instructions before taking medication. that you see a doctor.
68 FAMILY ILLNESS Assessing symptoms (adults) Symptoms take many forms. Some involve a new sensation; others involve a change in a normal body function. Certain symptoms can be assessed very accurately because they can be measured, for example by taking a temperature or a pulse. Others need careful and regular attention to assess whether something has changed, such as breast or testes examinations. MEASURING BODY TEMPERATURE 1 Insert thermometer 2Assess • Place a digital thermometer in the result mouth, with the tip under the tongue, and leave it until you hear • A result above it “beep”, indicating that it has measured the temperature. 100.4°F (38°C) indicates a fever. TAKING A PULSE 1 Find pulse 2Assess result • Place the pads of two fingers • A rate of around 72 beats per on the inside of a person’s minute is normal for an adult. wrist, just below the base • Note the quality of the pulse: of the thumb. if it is regular or irregular, strong or weak. • Press firmly to feel the Place the pads of the throbbing beat of fingers below the the pulse. victim’s thumb • Count the number of beats per minute. CHECKING BREATHING RATE 1 Count breaths 2Assess result • Watch for chest movement or place • The normal resting breathing rate your hand on the adult’s chest or is 12–15 breaths per minute. back so you can feel the breaths. • Note the quality of the person’s • Count the number of breaths he breathing: if it is fast or slow, or she takes in one minute. easy or labored.
ASSESSING SYMPTOMS (ADULTS) 69 ASSESSING WEIGHT Check whether you are lb kg HEIGHT/WEIGHT GRAPH FOR MEN AND WOMEN a healthy weight by using the graph (right). Trace 210 95 a vertical line from your height and a horizontal WEIGHT 200 90 OVERWEIGHT line from your weight. (BMI > 25) The point at which the 190 85 lines cross is your body HEALTHY WEIGHT mass index (BMI), which 180 (BMI 20-25) indicates whether or not 80 you are within a healthy range. Being a healthy 170 weight decreases the 75 risk of cardiovascular disease and many other 160 health problems. 70 150 65 140 130 60 120 55 110 50 UNDERWEIGHT 100 45 (BMI < 20) 90 40 144 146 148 150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 182 184 186 188 190 192 194 cm 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 75 in HEIGHT BREASTS: SELF-EXAMINATION 1 Examine yourself 2Feel each breast in a mirror • Lie down with one arm behind your head and firmly press each • The best time to check your breasts breast in small circular movements. • Feel around the entire breast, is just after your menstrual period. armpit area, and nipple. • If you discover • Stand in front of a mirror and a lump or any changes, consult look closely for your doctor. dimpled skin and any changes to Feel the breast and your nipple or up into the armpit to the size or shape of your breasts. TESTES: SELF-EXAMINATION 1 Look for changes 2Feel for lumps • The best time to examine your • Feel across the entire surface of testes is just after a bath or shower each testis by rolling it slowly when the scrotum is relaxed. between fingers and thumb. • Check the skin of your scrotum • Check for lumps and swellings. • Consult your doctor immediately for changes in appearance. if you detect any change in appearance or texture.
70 FAMILY ILLNESS Assessing symptoms (children) When a child is not well, temperature, pulse, and breathing rate are important symptoms to assess. To monitor your child’s growth, use the height and weight charts (opposite) to assess whether he or she is within normal ranges. MEASURING BODY TEMPERATURE 1 Insert thermometer 2Assess result • Place a digital thermometer under • For a mouth or ear reading, the tongue (for a child over 7) a result above 100.4°F (38°C) or under the armpit indicates a fever. and leave it until you • For an armpit reading, hear it “beep,” a result above 99°F indicating that it (37.4°C) indicates a fever. has measured the temperature. Hold the digital thermometer securely • Insert the tip in place of an aural thermometer into the ear. The reading is taken in 1 second. TAKING A PULSE 1 Find pulse 2Assess result • For a baby, place two fingers on • Count the number of beats you the inner side of the arm, halfway can feel in one minute. between the elbow and • A rate of around 140 beats per the armpit. minute is normal for a baby, 120 per minute for a • For a child, place your toddler, and 100 per minute for an older child. fingers on the inside • Note the quality of the of the wrist, just pulse: if it is regular or below the base of irregular, strong or weak. the thumb. Find a pulse on the inside of the arm
ASSESSING SYMPTOMS (CHILDREN) 71 CHECKING BREATHING RATE 1 Count breaths 2Assess result • Place your hand on the • Compare the child’s breathing rate child’s chest or back so with the maximum rate for his or that you are able to her age shown in the table below. feel the breaths. • Note the quality of the breathing: • Count the number of if it is fast or slow, easy or labored. breaths he or she takes in 1 minute. AGE BREATHS PER MINUTE Use your hand to Under 2 months Maximum of 60 breaths feel how fast the 2–11 months Maximum of 50 breaths baby is breathing 1–5 years Maximum of 40 breaths Over 5 years Maximum of 30 breaths ASSESSING HEIGHT AND WEIGHT Find your child’s age on the bottom and shows the normal range of growth, and follow a vertical line up, then find the the 5th, 50th, and 95th percentile lines height or weight on the left and follow a indicate lower, middle, and upper limits horizontal line across. Mark the point respectively. If your child’s measurements where the lines cross. The shaded band fall outside the band, see your doctor. in cm BOYS’ HEIGHT in cm GIRLS’ HEIGHT 70 180 95th percentile 70 180 95th percentile 170 170 50th percentile 50th percentile 65 65 160 5th percentile 160 5th percentile 60 150 1 2 3 4 5 6 7 8 9 10 11 12 60 150 1 2 3 4 5 6 7 8 9 10 11 12 AGE (years) AGE (years) 55 140 55 140 50 130 50 130 120 120 45 45 110 110 40 100 40 100 35 90 35 90 80 80 30 30 70 70 25 60 25 60 20 50 20 50 40 40 0 0 lb kg BOYS’ WEIGHT lb kg GIRLS’ WEIGHT 70 70 95th percentile 95th percentile 140 140 60 50th percentile 60 50th percentile 120 5th percentile 120 5th percentile 50 50 100 100 40 40 80 80 30 30 60 60 40 20 40 20 20 10 20 10 0 0 0 1 2 3 4 5 6 7 8 9 10 11 12 0 1 2 3 4 5 6 7 8 9 10 11 12 AGE (years) AGE (years)
72 FAMILY ILLNESS Do you have any of the Not feeling well following? There may be times when don’t feel well but are Feeling unable to pinpoint a precise symptom. This feeling constantly is commonly caused by the onset of a minor viral on edge illness, psychological pressures, or simply an unhealthy lifestyle. You should always consult Difficulty your doctor if the feeling persists because there sleeping may be a more serious underlying problem. Inability to START Do you have Have you lost concentrate a fever – a more than or to make temperature of 10 lb (4.5 kg) decisions 100.4°F (38°C) over the past None of or above? 10 weeks the above without Fever changing your Are you taking eating habits? any medication? No fever Lost over 10 lb Medication (4.5 kg) No medication Lost under 10 lb (4.5 kg) or ACTION gained weight MAKE AN APPOINTMENT TO SEE YOUR DOCTOR ACTION ACTION Your symptoms may GO TO ANOTHER CHART SEE YOUR DOCTOR be a side effect of the medication. Fever (adults), p.74 or WITHIN 24 HOURS Fever (children), p.76 • Stop taking any over- There are a number Safe alcohol limits of possible causes for the-counter medicines rapid weight loss, and but continue to take One unit of alcohol equals it is important to see prescribed medication half a pint of beer, a small your doctor to rule unless advised to stop glass of wine or sherry, or out potentially serious by your doctor. one measure of hard liquor. conditions such as diabetes mellitus. •The maximum recommended limit for men is 3 units a day. •The maximum recommended limit for women is 2 units a day.
ACTION ACTION NOT FEELING WELL 73 MAKE AN APPOINTMENT TRY SELF-HELP MEASURES ACTION TO SEE YOUR DOCTOR Body changes that TRY SELF-HELP MEASURES Your symptoms may occur soon after be due to an anxiety conception can make You may have a mild disorder or depression. you feel unwell. digestive upset as a Symptoms include result of infection or • Try physical exercise fatigue, feeling faint, having eaten something and nausea/vomiting. that disagrees with you. or some relaxation Your symptoms are not techniques (p.169); • Eat frequent small likely to be dangerous, they may help to but severe diarrhea can alleviate the symptoms. meals throughout the cause dehydration, day rather than a few particularly in the Might you be larger meals. If you elderly or very young. pregnant? suffer from morning sickness, eat a snack • Avoid rich or spicy Possibly before getting up. pregnant foods and drink plenty • Lie down if you are of clear fluids. Not pregnant feeling faint or tired. CONSULT YOUR DOCTOR Are you feeling more • If you are not sure if you do not feel better within 2 days or sooner tired than whether you are for a child. usual? pregnant, use a home pregnancy test or Do you have More tired consult your doctor. any of the following? No change Do you regularly drink more Loss of appetite ACTION than the Nausea and/or MAKE AN APPOINTMENT recommended vomiting TO SEE YOUR DOCTOR limit of alcohol (see box opposite)? Diarrhea if your fatigue is persistent or severe and Within the limit None of has no obvious cause. the above More than the limit ACTION ACTION MAKE AN APPOINTMENT TO SEE YOUR DOCTOR MAKE AN APPOINTMENT TO SEE YOUR DOCTOR if you cannot identify a possible cause for for advice about not feeling well from reducing the amount this chart. of alcohol you drink. Regularly drinking too much alcohol can make you not feel well.
74 FAMILY ILLNESS Fever (adults) For children under 12, see p.76 ! High temperature Normal temperature varies from one person to If you are not feeling well, another, but if your temperature is 100.4°F (38°C) you should take your or above, you have a fever. Most fevers are due to temperature every 4 hours. infection, but heat exposure or certain drugs can • Call your doctor immediately also raise body temperature. In all cases, follow if your temperature rises to the advice for bringing down a fever (p.164). 102°F (39°C) or above. • Take steps to lower the fever START Do you have ACTION without delay (see Bringing a rash? down a fever, p.164). GO TO ANOTHER CHART Rash Are you having No rash Rash with fever, p.96 problems breathing? Do you have Do you have any of the a headache? You are short following? of breath Severe Drowsiness headache Breathing or confusion is painful Mild Dislike of headache Breathing bright light No headache is normal Neck pain on Do you have ACTION bending the a cough? head forwards CALL YOUR DOCTOR NOW Cough None of You may have a chest the above infection, such as pneumonia. ACTION No cough • Follow the advice !DIAL 911 OR CALL EMS You may have for bringing down a meningitis (infection fever (p.164). inflaming membranes around the brain). ACTION GO TO ANOTHER CHART Sore throat, p.103
Have you been ACTION FEVER (ADULTS) 75 coughing up sputum? TRY SELF-HELP MEASURES ACTION Sputum You probably have a TRY SELF-HELP MEASURES viral illness, such as No sputum a severe cold or flu. You may have a viral chest infection, such Do you have • Follow the advice as acute bronchitis. either of the following? for bringing down a • Follow the advice General aches fever (p.164). for bringing down a and pains • Try inhaling steam fever (p.164). Runny nose from a bowl of hot • Drink plenty of fluids. Neither water (p.165). • If you smoke, stop. Do you have CONSULT YOUR DOCTOR CONSULT YOUR DOCTOR problems with if your symptoms if your symptoms urination? worsen, if you are no worsen or if you are better within 2 days, no better within 2 days. Painful or if any other Abnormally symptoms develop. ACTION frequent ACTION SEE YOUR DOCTOR Neither WITHIN 24 HOURS SEE YOUR DOCTOR Do you have WITHIN 24 HOURS A long-term infection, a sore throat? such as infective You may have cystitis endocarditis (inflamed Sore throat or a urine infection lining of the heart), or that has spread to one an AIDS-related illness No sore throat or both kidneys. may cause recurrent fever. Another possible • For both conditions, cause is an underlying cancer, such as take an analgesic such lymphoma (cancer of as acetaminophen. the lymphatic system). • Drink 500 ml (1 pt) ACTION of fluid every hour for SEE YOUR DOCTOR 4 hours. WITHIN 24 HOURS • Drinking cranberry if you cannot identify a possible cause for your juice may help relieve fever from this chart. the burning sensation. Have you had several bouts of fever over the past few weeks? Recurrent fever No other recent fever
76 FAMILY ILLNESS Fever (children) For adults and children over 12, see p.74 ! Danger signs A fever is a temperature of 100.4°F (38°C) or above. Dial 911 or call EMS if your If your child is not feeling well, you should take his child’s temperature rises or her temperature because a high fever may need above 102°F (39°C) and he urgent treatment. If a feverish child becomes or she has any of the unresponsive, dial 911 or call EMS. In all cases, following symptoms: follow the advice for bringing down a fever (p.164). • Abnormally rapid breathing (see p.71). START How old is ACTION • Abnormal drowsiness. your child? • Severe headache. CALL YOUR DOCTOR NOW • Dislike of bright light. Under 6 months • Refusal to drink for more Fever in young babies than 6 hours. 6 months is unusual unless it or over occurs within 48 hours Is your child of immunization. Fever reluctant to may indicate an illness that could be serious. move an arm or leg? Does your Does your Yes child have child have any of the No a rash? following? ACTION Rash Severe headache CALL YOUR DOCTOR NOW No rash Abnormal Your child could have ACTION drowsiness, an infection in a bone, irritability, such as osteomyelitis, GO TO ANOTHER CHART or confusion or a joint infection. Rash with fever, p.96 Dislike of ACTION bright light ACTION SEE YOUR DOCTOR Neck pain on WITHIN 24 HOURS !DIAL 911 OR CALL EMS bending the Your child may have head forwards Your child may have meningitis. acute otitis media None of (middle-ear infection). • Follow the advice the above • Give liquid acet- for bringing down a fever (p.164). aminophen to relieve pain and reduce fever.
ACTION Does your FEVER (CHILDREN) 77 child have !DIAL 911 OR CALL EMS either of the ACTION Your child could following? have a respiratory TRY SELF-HELP MEASURES infection, such as Cough pneumonia. Your child probably has Runny nose a viral illness, such as a • Give liquid acet- severe cold or flu. Neither aminophen to relieve • Follow the advice pain and reduce fever. Does your child have a for bringing down a Is your child’s sore throat? fever (p.164). breathing abnormally Sore throat • Try inhaling steam noisy or rapid No sore throat from a bowl of hot (see p.71)? water (p.165). Does your Abnormally child have CONSULT YOUR DOCTOR rapid either of the following? if your child’s condition Noisy worsens, if he or she is Painful no better within 2 days, Neither urination or if he or she develops Diarrhea with other symptoms. ACTION or without vomiting ACTION CALL YOUR DOCTOR NOW Neither TRY SELF-HELP MEASURES This may be croup, in which a viral infection ACTION Your child may have a inflames the airways. throat infection, such SEE YOUR DOCTOR as tonsillitis. • Sit with your child WITHIN 24 HOURS • Follow the advice in a steamy bathroom if you cannot identify to ease the breathing. a possible cause for for bringing down a your child’s fever from fever (p.164). Does either of this chart. the following • Follow the advice apply? for soothing a sore throat (p.164). Your child has been pulling CONSULT YOUR DOCTOR at one ear if your child is no better in 24 hours or if other Your child has symptoms develop. complained of ACTION earache SEE YOUR DOCTOR Neither WITHIN 24 HOURS Your child may have a urinary tract infection. • Give plenty of fluids to drink. ACTION CALL YOUR DOCTOR NOW if your child is under 1 year. He or she may have gastroenteritis. • Give older children plenty of clear fluids to drink.
78 FAMILY ILLNESS Excessive sweating Sweating is one of the body’s cooling mechanisms. Do you feel It is a normal response to heat, exercise, and stress otherwise or fear. Some people naturally sweat more than others. Wearing natural fibers, such as cotton, well? and using an antiperspirant often help to reduce sweating. You should consult your doctor if you Well sweat excessively and are unsure of the cause. Unwell START Do you have When does a fever – a the sweating ACTION temperature of occur? MAKE AN APPOINTMENT 100.4°F (38°C) TO SEE YOUR DOCTOR Mainly at night or above? Hormonal changes At other times associated with the Fever menstrual cycle or menopause may cause No fever excessive sweating. ACTION Do you have Does either of any of the the following GO TO ANOTHER CHART following? apply? Fever (adults), p.74, or Weight loss Sweating occurs Fever (children), p.76 with increased with menstrual ACTION appetite periods Menstrual MAKE AN APPOINTMENT Feeling periods have TO SEE YOUR DOCTOR constantly on edge become You may be suffering irregular from hyperthyroidism Bulging eyes (an overactive thyroid Neither gland). However, None of anxiety disorders the above are another possible cause of some of these symptoms.
ACTION ACTION EXCESSIVE SWEATING 79 SEE YOUR DOCTOR TRY SELF-HELP MEASURES ACTION WITHIN 24 HOURS Being overweight can TRY SELF-HELP MEASURES You may have a chronic lead to excessive infection, such as sweating, particularly Excessive sweating of tuberculosis, or a cancer, after physical exertion. the hands and feet is a such as lymphoma common problem. (cancer of the • Adopt a sensible lymphatic system). • Wash off sweat weight-reducing diet. Is your weight regularly and wear within ideal • Wash away sweat socks made from limits? natural fibers. Try to regularly and wear go barefoot whenever Overweight comfortable loose possible. clothing made from Ideal weight natural fibers. CONSULT YOUR DOCTOR Underweight CONSULT YOUR DOCTOR if your symptoms do not improve. ACTION if your symptoms do not improve. Is the sweating MAKE AN APPOINTMENT limited to TO SEE YOUR DOCTOR Do you regularly drink more certain parts for advice about than the of the body? reducing the amount of alcohol you drink. recommended Mainly hands limit of alcohol ACTION (see box below)? Mainly feet MAKE AN APPOINTMENT More than Other parts TO SEE YOUR DOCTOR the limit affected Your symptoms may Within the limit ACTION be a side effect of the medication. Are you SEE YOUR DOCTOR currently taking WITHIN 24 HOURS • Stop taking any over- any medication? if you cannot identify the-counter medicines Medication a possible cause from but continue to take this chart. prescribed medication No medication unless advised to stop Safe alcohol limits by your doctor. One unit of alcohol equals half a pint of beer, a small glass of wine or sherry, or one measure of hard liquor. •The maximum recommended limit for men is 3 units a day. •The maximum recommended limit for women is 2 units a day.
80 FAMILY ILLNESS Lumps and swellings Enlarged lymph nodes (glands) are often the cause ! Painless lumps or of lumps and swellings under the skin, particularly swellings in the neck, under the arms, or in the groin. These glands usually become swollen due to an infection. Any painless lump or swelling The swelling subsides shortly after the infection clears that does not disappear up. If the lumps are painful or if they are persistent within 2 weeks should be but painless, you should consult your doctor. seen by a doctor. Although in most cases the cause is not serious, a painless lump may be a sign of cancer. Early treatment can be lifesaving. START What are the Are the lumps characteristics or swellings in more than of the lump or swelling? one area? Red and painful One area only Other Several areas Do you have a rash? ACTION Do you have Rash a fever – a SEE YOUR DOCTOR No rash WITHIN 24 HOURS temperature of 100.4°F (38°C) ACTION You may have an abscess or a boil. or above? SEE YOUR DOCTOR WITHIN 24 HOURS • Relieve pain by Fever You may be suffering putting a clean cloth No fever from infectious soaked in hot water mononucleosis, on the affected area especially if you’re for 30 minutes four generally not times a day. feeling well. ACTION • Drink plenty of SEE YOUR DOCTOR cool fluids. WITHIN 24 HOURS • Take acetaminophen A viral infection is the most likely cause. to reduce your fever. Lymphoma (cancer of the lymphatic system) or an AIDS-related illness are also possibilities.
ACTION What happens LUMPS AND SWELLINGS 81 to the swelling GO TO ANOTHER CHART ACTION if you press Testes and scrotum on it or if you MAKE AN APPOINTMENT problems, p.151 TO SEE YOUR DOCTOR lie down? Where is You may have a hernia. the lump or It disappears ACTION swelling? It reduces in size MAKE AN APPOINTMENT Testis TO SEE YOUR DOCTOR No change Groin Lymph nodes in the ACTION groin often become Breast swollen in response GO TO ANOTHER CHART to an infection. Sides or back of neck Breast problems, p.154 Other Do you have a ACTION sore throat? ACTION GO TO ANOTHER CHART Sore throat SEE YOUR DOCTOR Sore throat, p.103 WITHIN 24 HOURS No sore throat ACTION A number of viral Do you have a illnesses can cause recent injury TRY SELF-HELP MEASURES swollen glands and a near the site of rash. Lyme disease (an the swelling? An injury is likely to infection that causes cause some swelling as a rash and flulike Injury a result of damage to symptoms) is another the tissues. An infected possibility, particularly No injury wound or a rash can if you think you may also cause nearby have been bitten by a lymph nodes to swell. tick recently. •Make sure the ACTION wound is clean and MAKE AN APPOINTMENT protect it with a TO SEE YOUR DOCTOR bandage or dressing. if you cannot identify a CONSULT YOUR DOCTOR possible cause for your lumps or swellings if there is any pain, from this chart. redness, or pus around the wound, or if the swelling persists after the wound has healed.
82 FAMILY ILLNESS Feeling faint /passing out A sensation of dizziness or lightheadedness may ! Unconsciousness be followed by passing out (loss of consciousness). If someone remains The cause is usually lack of food or a reduction in unconscious for more than blood flow to the brain. A brief episode of feeling a minute or so, whatever the faint without other symptoms is not a cause for suspected cause, you should alarm, but you should consult your doctor if such get emergency medical help. episodes recur or if you have passed out. • If you need to leave the person to call for help, Have you had Have you first lay him or her in the noticed any of recovery position (pp.14–15). START any of the the following? • Do not move the person if you suspect spinal injury. following? Bloodstained vomit Did any of the Disturbed vision following occur Red blood in Numbness, the feces when you weakness, passed out? or tingling Black, tarry feces You twitched Confusion uncontrollably None of Difficulty the above You bit your speaking tongue ACTION None of You urinated the above !DIAL 911 OR CALL EMS You may have some None of Are any of the bleeding within the the above symptoms still digestive tract, perhaps from a stomach ulcer ACTION present? (an eroded area of the stomach lining) or !DIAL 911 OR CALL EMS Symptoms from an inflammation if this is your first present in the colon. attack. You may have had a seizure, possibly Symptoms no due to epilepsy. longer present CONSULT YOUR DOCTOR ACTION ACTION if you have had !DIAL 911 OR CALL EMS CALL YOUR DOCTOR NOW previous similar attacks. You may have had a stroke. You may have had a mini-stroke.
FEELING FAINT/PASSING OUT 83 ACTION Does either of ACTION the following TRY SELF-HELP MEASURES CALL YOUR DOCTOR NOW apply? Sudden shock can lead Low blood sugar (which to feeling faint or even You have may be due to excessive passing out. diabetes insulin treatment) could be the cause. • Rest and ask someone You had not eaten for several • Eat or drink to stay with you until you feel better. hours before something sugary now. passing out • Follow the first-aid ACTION Neither advice for treating SEE YOUR DOCTOR fainting (p.53) Do you have WITHIN 24 HOURS any of the CONSULT YOUR DOCTOR following? You may be anemic. This can be confirmed if it happens again. Shortness by a blood test. of breath Did you feel ACTION faint or pass out Paler skin than normal MAKE AN APPOINTMENT immediately TO SEE YOUR DOCTOR after either of Inordinate the following? fatigue Fainting is common in early pregnancy. If you Emotional None of are not sure whether shock the above you are pregnant, do a home pregnancy test. Getting up Does either of suddenly the following Might you be pregnant? Neither apply? Possibly ACTION You have had pregnant chest pain or SEE YOUR DOCTOR you have a Not pregnant WITHIN 24 HOURS heart condition ACTION if you passed out, or in You have had the next few days even palpitations CALL YOUR DOCTOR NOW if you did not pass out. The most likely cause Neither if you passed out is a temporary drop in and cannot identify blood pressure due to a possible cause from a change in position. this chart. ACTION SEE YOUR DOCTOR WITHIN 24 HOURS CALL YOUR DOCTOR NOW if you cannot identify You may have low a possible cause for blood pressure due to feeling faint. an irregular heartbeat or worsening of an existing heart condition.
84 FAMILY ILLNESS ! Danger signs Dial 911 or call EMS if a Headache headache is accompanied by any of the following Fever and tension in head and neck muscles are symptoms: common causes of headache. Too much alcohol, • Drowsiness or confusion. caffeine, or nicotine may also cause headache. Most • Weakness of a limb. headaches do not last for more than a few hours. If • Blurred vision. your headache lasts for more than 24 hours, is not • Dislike of bright light. improved by over-the-counter analgesics, or recurs • Temporary unconsciousness. several times in a week, consult your doctor. ACTION START Have you hit Do you have your head a fever – a GO TO ANOTHER CHART within the past temperature of Fever (adults), p.74, or 24 hours? 100.4°F (38°C) Fever (children), p.76 Head injury or above? No head injury Fever No fever Are danger ACTION Have you signs present experienced (see box above TRY SELF-HELP MEASURES nausea and/or right) or have vomiting with you vomited? A mild headache is the headache? common following a Danger signs minor head injury. Yes present • Take an analgesic No Vomited after head injury (not aspirin). No danger signs CALL YOUR DOCTOR or vomiting IMMEDIATELY ACTION if your headache lasts for more than 2 hours !DIAL 911 OR CALL EMS or if you develop other There may be damage symptoms. to the tissues that surround the brain. ACTION TRY SELF-HELP MEASURES Sinusitis is the likely cause of your headache. • Try inhaling steam from a bowl of hot water (p.165). CONSULT YOUR DOCTOR if you feel no better within 2 days.
How is your ACTION HEADACHE 85 vision? CALL YOUR DOCTOR NOW ACTION Blurred vision Acute glaucoma (a MAKE AN APPOINTMENT Disturbed in painful, rapid rise TO SEE YOUR DOCTOR other ways in fluid pressure in the eye) is a possibility, Your symptoms may Unchanged particularly if the pain be side effects of the is around your eye. medication. ACTION Where is the • Stop taking any over- CALL YOUR DOCTOR NOW pain? the-counter medicines You have probably a Over one or but continue to take migraine, particularly both temples prescribed medication if any visual problems unless advised to stop occurred before the Elsewhere by your doctor. headache. However, the slight chance of a ACTION Are you taking more serious disorder, any medication? such as a stroke, needs CALL YOUR DOCTOR NOW to be ruled out if this Medication is your first migraine. You may have temporal arteritis (inflammation No medication • Take an analgesic of blood vessels in the head), particularly if Have you had and sips of water. you are over 50 and this type of are not feeling well. headache • Rest in a darkened, before? ACTION quiet room until the Yes pain subsides. MAKE AN APPOINTMENT If you have had any TO SEE YOUR DOCTOR No previous attacks, try to identify and avoid if you cannot identify ACTION potential triggers, such a possible cause for as chocolate. your headache from MAKE AN APPOINTMENT this chart. TO SEE YOUR DOCTOR Does either of the following A recurrent headache for which there is no apply? obvious cause, such as drinking too much The pain is felt alcohol, should always chiefly in the be investigated fully areas above and by your doctor. below the eyes You have recently had a runny or stuffy nose Neither
86 FAMILY ILLNESS Vertigo The unpleasant sensation that your surroundings ! Recurring attacks are moving around you is known as vertigo. It is of vertigo often associated with nausea and vomiting. Healthy If you have been experiencing people may experience vertigo temporarily after a attacks of vertigo, it is very ride at an amusement park or after drinking too important to avoid certain much alcohol. You should consult your doctor if activities that are potentially you develop vertigo for no obvious reason. hazardous to you and others. You should not climb ladders Have you had Have you or steep flights of stairs, noticed either of operate machinery, or drive START any of the the following? until the cause of your symptoms has been following? Hearing loss diagnosed and treated. Numbness, Ringing in tingling, or Have you weakness the ears experienced Neither either of the Disturbed vision following? ACTION Confusion Nausea or !DIAL 911 OR CALL EMS vomiting Difficulty You may have had speaking a stroke. Difficulty None of keeping your the above ACTION balance Are any of these CALL YOUR DOCTOR NOW symptoms still Neither present? You may have had a Symptoms mini-stroke. ACTION present Symptoms no !DIAL 911 OR CALL EMS longer present You may have had a stroke. Your symptoms may also be caused by labyrinthitis (inflamed inner ear). • You can minimize the symptoms of labyrinthitis by lying down or trying to move around as little as possible.
ACTION ACTION VERTIGO 87 SEE YOUR DOCTOR CALL YOUR DOCTOR NOW ACTION WITHIN 24 HOURS Your symptoms may TRY SELF-HELP MEASURES be a side effect of your You could be suffering medication. Your symptoms are from Ménière’s disease most likely to be (a disorder of the inner • Stop taking any over- caused by drinking ear, which contains more alcohol than the organs of balance the-counter medicines usual or drinking on and hearing). but continue to take an empty stomach. prescribed medication • Lie still in a darkened unless advised to stop • The effects of by your doctor. room with your eyes alcohol should wear closed and avoid noise. off within a few hours. Acoustic neuroma • Meanwhile, drink (a noncancerous tumor of the nerve that plenty of water. connects the ear to the brain) is another, CONSULT YOUR DOCTOR although less likely, possibility. if the sensation persists for more than 12 hours. Are you Have you How old currently taking been drinking are you? any medication? alcohol? 50 or over Medication Under 50 Yes No medication ACTION No ACTION SEE YOUR DOCTOR Does turning WITHIN 24 HOURS MAKE AN APPOINTMENT or raising your TO SEE YOUR DOCTOR head bring on if you cannot identify a possible cause for your Your vertigo may be vertigo? vertigo from this chart. caused by osteoarthritis Brings on affecting the bones and cartilage of the vertigo upper spine (cervical No noticeable spondylosis). This can cause pressure on the effect blood vessels of the areas of the brain that affect balance. •Try to avoid making any sudden or extreme head movements.
88 FAMILY ILLNESS Numbness and/or tingling Almost everyone has experienced numbness, the ! Danger signs loss of sensation in a part of the body, after sitting Dial 911 or call EMS if the or lying in an awkward position for some time. numbness and/or tingling is Tingling, a prickly feeling, often occurs as sensation accompanied by any of the returns to a numb area. You should consult this following symptoms: chart if you experience numbness and/or tingling • Feeling faint or passing out. for which there is no obvious cause. • Disturbed vision. • Confusion. START Did the ACTION • Difficulty speaking. numbness • Weakness in a limb. TRY SELF-HELP MEASURES and/or Does either of tingling occur Pressure on nerves or the following on the blood vessels in either of that supply them is apply? the following the most likely cause. circumstances? Numbness and/or • Change position and tingling is worse After sitting in one position massage the affected at night for a long time area. Normal sensation should return within a Pain shoots On waking few minutes. into palm from a of hand CONSULT YOUR DOCTOR deep sleep Neither if the numbness or Neither tingling feeling persists for longer than 1 hour. Have you noticed any stiffness in your neck? No stiff neck Stiff neck ACTION Where is the MAKE AN APPOINTMENT numbness TO SEE YOUR DOCTOR and/or tingling? You may have cervical spondylosis (a type of Hand or arm osteoarthritis that affects the upper spine). Elsewhere
NUMBNESS AND/OR TINGLNG 89 ACTION Have you had ACTION any of the MAKE AN APPOINTMENT following !DIAL 911 OR CALL EMS TO SEE YOUR DOCTOR symptoms? You may have had a stroke. You probably have Feeling faint carpal tunnel syndrome or passing out Are any (tingling and pain in of these the hand and forearm Disturbed vision symptoms due to a compressed still present? nerve at the wrist). Confusion Symptoms • Avoid positions that Difficulty present speaking worsen the symptoms. Symptoms no Weakness longer present Are the affected in a limb areas on only one side of None of the body? the above One side only Do your fingers ACTION become numb Both sides and white or CALL YOUR DOCTOR NOW blue in either ACTION of the following You may have had a circumstances? mini-stroke. MAKE AN APPOINTMENT TO SEE YOUR DOCTOR In cold weather ACTION This type of numbness When using MAKE AN APPOINTMENT is most likely caused vibrating TO SEE YOUR DOCTOR by hand–arm machinery syndrome, which is You may be suffering associated with the Neither from Raynaud’s long-term use of phenomenon, in which vibrating machinery. ACTION there is intermittent narrowing of blood • Avoid using MAKE AN APPOINTMENT vessels in the hands or, TO SEE YOUR DOCTOR rarely, the feet. vibrating machinery. if you cannot identify • Keep your hands • Keep warm. a possible cause for • If you smoke, stop. your numbness and/or and/or feet warm. tingling from this chart. • If you smoke, stop.
90 FAMILY ILLNESS Do any of the following Facial pain apply? Pain in the face may be sharp and stabbing or dull Your scalp is and throbbing, and is most often caused by an sensitive to touch inflammation of structures in the face, such as the sinuses or teeth. Facial pain is usually short-lived, You don’t feel but some types, such as neuralgia, may persist. well Consult your doctor if the pain is persistent, unexplained, or is not relieved by analgesics. Pain comes on when chewing START Where is ACTION the pain? None of GO TO ANOTHER CHART the above Over one or both temples Eye pain or ACTION irritation, p.98 In or around TRY SELF-HELP MEASURES the eye ACTION You probably have Elsewhere CALL YOUR DOCTOR NOW sinusitis, especially if you have recently had ACTION You may have temporal a cold and both sides of arteritis (inflammation your face are affected. MAKE AN APPOINTMENT of blood vessels around If only one side is TO SEE YOUR DOCTOR the head), especially if affected, a dental you are over 50. problem, such as an You may have abscess, is more likely. trigeminal neuralgia Which of the (severe pain due to following • Take an analgesic an irritated nerve). describes your pain? such as acetaminophen. • Try to avoid triggers Stabbing pain • Try inhaling steam if possible. when touching from a bowl of hot ACTION the face or water (p.165) if you chewing think you have sinusitis. MAKE AN APPOINTMENT TO SEE YOUR DOCTOR Aching pain CONSULT YOUR DOCTOR OR DENTIST on chewing OR DENTIST and/or yawning You may have a if you do not feel disorder in the joint Dull aching better within 2 days. between the jaw and around one the skull. ACTION or both • Take acetaminophen cheekbones MAKE AN APPOINTMENT TO SEE YOUR DOCTOR to relieve the pain. None of the above if you cannot identify • Hold a wrapped a possible cause for your facial pain from heating pad against the this chart. affected area.
FACIAL PAIN • DIFFICULTY SPEAKING 91 Difficulty speaking Slurred or unclear speech and the inability to find ACTION or use words are symptoms that may have an obvious cause, such as drinking too much alcohol. !DIAL 911 OR CALL EMS But difficulty speaking can also signal a more You may have had serious condition affecting the brain’s speech a stroke. centers. If your speech suddenly deteriorates, consult your doctor urgently. ACTION Have you had Are any CALL YOUR DOCTOR NOW symptoms START any of the still present? You may have had a mini-stroke. following? Symptoms present ACTION Disturbed vision Symptoms no SEE YOUR DOCTOR Numbness, longer present WITHIN 24 HOURS tingling, or weakness ACTION Your symptoms may be a side effect of Feeling faint CALL YOUR DOCTOR NOW medication or drugs. or passing out You may have a type • Stop taking any over- Confusion of facial palsy, due to damaged facial nerves. the-counter medicines Inability to but continue to take move the •Take care of your prescribed medication muscles on one unless advised to stop side of the face eyes, which may not by your doctor. close fully. None of ACTION the above Do any of these apply? MAKE AN APPOINTMENT ACTION TO SEE YOUR DOCTOR You have been MAKE AN APPOINTMENT taking drugs or for advice on reducing TO SEE YOUR DOCTOR your alcohol intake. medication You may have glossitis ACTION (inflamed tongue). You have been drinking alcohol SEE YOUR DOCTOR • Rinse your mouth WITHIN 24 HOURS You have a regularly with either sore mouth if you cannot identify a salt solution or a or tongue a possible cause for pain-relieving your speech difficulty mouthwash. None of from this chart. the above • Avoid acidic and spicy foods. • If you smoke, stop.
92 FAMILY ILLNESS Forgetfulness or confusion Most people are forgetful sometimes, especially ! Sudden onset of if they are very busy. Absent-mindedness is also confusion a natural part of the aging process. Confusion is the inability to think clearly and may include Call a doctor immediately if forgetfulness. You should consult your doctor if a person suddenly becomes episodes of forgetfulness and/or confusion occur very confused or disoriented frequently or are severe enough to disrupt your life. about time or place, or seems to be seeing or hearing things that are not there. START Has the Have you had Do you have forgetfulness any of the a fever – a following? and/or temperature of confusion Disturbed vision 100.4°F (38°C) come on since a head injury? Numbness, or above? tingling, or Head injury weakness Fever Vertigo or loss No head injury of consciousness No fever Difficulty ACTION ACTION speaking CALL YOUR DOCTOR NOW None of CALL YOUR DOCTOR NOW the above Damage to the brain, Fever, especially a such as that resulting Are any of these temperature that is over from a hard blow, may symptoms still 102°F (39°C), may cause such symptoms. present? itself be a cause of In some cases, the confusion. However, effects may be delayed. Symptoms confusion can also be present due to a number of ACTION serious conditions, Symptoms no such as pneumonia. CALL YOUR DOCTOR NOW longer present • Follow the advice You may have had a mini-stroke. for bringing down a fever (p.164). ACTION !DIAL 911 OR CALL EMS You may have had a stroke.
FORGETFULNESS OR CONFUSION 93 Do you suffer ACTION ACTION from any of the following? CALL YOUR DOCTOR NOW CALL YOUR DOCTOR NOW Diabetes Lack of oxygen to Confusion may indicate mellitus the brain caused by low or very high blood the worsening of an sugar levels in someone Heart disease existing heart or with diabetes. lung disease may Lung disease cause confusion. • Eat or drink None of something sugary now. the above Have you been ACTION Are you drinking alcohol currently taking within the past MAKE AN APPOINTMENT any medication? few hours? TO SEE YOUR DOCTOR Medication Yes for advice about No medication reducing the amount No of alcohol you drink. ACTION Drinking too much alcohol can cause SEE YOUR DOCTOR confusion and, more WITHIN 24 HOURS seriously, can also lead to loss of memory. Your symptoms may be a side effect of Is gradually ACTION medication or drugs. increasing forgetfulness MAKE AN APPOINTMENT • Stop taking any over- and confusion TO SEE YOUR DOCTOR in an elderly the-counter medicines These symptoms may but continue to take person indicate a decline in prescribed medication accompanied mental function due unless advised to stop by any of the to a condition such as by your doctor. dementia. Depression following? may also cause similar symptoms. Personality change ACTION Reduced MAKE AN APPOINTMENT attention to TO SEE YOUR DOCTOR personal hygiene if you cannot identify Inability a possible cause for to manage your forgetfulness everyday and/or confusion from problems this chart. None of the above
94 FAMILY ILLNESS General skin problems Skin problems are often caused by local infection, ACTION allergy, or irritation. They are usually not serious, although widespread skin problems may be distressing. GO TO ANOTHER CHART You should consult your doctor if: a skin problem lasts more than a month or causes severe discomfort; Rash with fever, p.96 a new lump appears, especially if it is dark-colored; or a sore fails to heal. Is the affected skin itchy? What type of Do you have Itchy a fever – a START skin problem Not itchy temperature of do you have? 100.4°F (38°C) What does the Rash area look like? or above? Other skin Painful, blistery problem Fever rash in one area ACTION No fever Reddened patches covered SEE YOUR DOCTOR Have you with silvery scales WITHIN 24 HOURS noticed any of the following? Blistery, oozing You may have cellulitis rash on or (infection of the skin Red, tender, and and underlying tissue). hot area of skin around the lips New mole or a ACTION A painful red change in an lump with a MAKE AN APPOINTMENT existing mole yellow center TO SEE YOUR DOCTOR An open sore that None of You may possibly have has not healed the above skin cancer. after 3 weeks None of ACTION the above TRY SELF-HELP MEASURES This may be a boil. • Apply a hot cloth for 30 mins, 4 times a day. CONSULT YOUR DOCTOR if the condition has not improved in 24 hours.
What does the What do the GENERAL SKIN PROBLEMS 95 affected skin edges of the rash look like? ACTION look like? Merge into TRY SELF-HELP MEASURES Areas of inflamed surrounding skin skin with a scaly You may have a form Clearly defined of eczema. surface margins • Follow the advice One or more red ACTION bumps with a for relieving itchiness MAKE AN APPOINTMENT (p.165). central dark spot TO SEE YOUR DOCTOR CONSULT YOUR DOCTOR Intermittent You may have a fungal red raised infection like ringworm. if your rash does not improve within 1 areas (wheals) ACTION week or if any other symptoms develop. None of TRY SELF-HELP MEASURES the above ACTION You may have been ACTION bitten by an insect. SEE YOUR DOCTOR WITHIN 24 HOURS TRY SELF-HELP MEASURES • Try using an You may have Lyme You may have urticaria. antihistamine cream. disease, which is carried by ticks. • Soothe the irritation Does either of the following ACTION with cold compresses or calamine lotion. apply? CALL YOUR DOCTOR NOW • Try over-the-counter You have a rash Your symptoms may be that spreads a side effect of the drug. antihistamine tablets. out from a • Stop taking any over- CALL YOUR DOCTOR NOW central red spot the-counter medicines if you are experiencing You have been but continue to take breathing difficulties. bitten by a tick prescribed medication unless advised to stop ACTION Neither by your doctor. SEE YOUR DOCTOR ACTION Are you WITHIN 24 HOURS currently taking SEE YOUR DOCTOR any medication? You may have shingles. WITHIN 24 HOURS Medication • Soothe the irritation You may have impetigo. No medication with cold compresses • Do not touch blisters. or calamine lotion. ACTION If you have had the • Take an analgesic same problem before, MAKE AN APPOINTMENT it could be a cold sore. TO SEE YOUR DOCTOR such as acetaminophen. • Use an over-the- if you cannot identify ACTION a possible cause for counter antiviral cream. your skin problem MAKE AN APPOINTMENT from this chart. TO SEE YOUR DOCTOR You may have psoriasis.
96 FAMILY ILLNESS Rash with fever For rash without fever, see p.94 ! Danger signs If you or your child has a temperature of 100.4°F Dial 911 or call EMS if a rash (38°C) or above, you should check whether a rash and fever are accompanied is also present. A rash with fever is usually caused by any of the following: by a viral infection, most of which are not serious. • Abnormal drowsiness. However, a rash may alert you to the possibility • Seizures. of potentially life-threatening meningitis. • Temperature of 102°F (39°C) or above. What are the ACTION • Abnormally rapid breathing (see advice on checking your START features of the SEE YOUR DOCTOR child’s breathing rate, p.71). WITHIN 24 HOURS • Noisy or difficult breathing. rash? • Severe headache. You may have Widespread itchy, chickenpox, which ACTION blistery rash may need treatment with an antiviral drug. SEE YOUR DOCTOR Rash that spreads WITHIN 24 HOURS from a central • Follow the advice red spot You may have Lyme for bringing down a disease (an infection Flat, dark red fever (p.164). transmitted by ticks spots that do that causes a rash and not fade when • Apply calamine flulike symptoms). pressed lotion to relieve the • Follow the advice itchiness of the rash. Dull red spots for bringing down a or blotches ACTION fever (p.164). that fade when SEE YOUR DOCTOR ACTION pressed WITHIN 24 HOURS SEE YOUR DOCTOR Bright red rash, Fifth disease (or WITHIN 24 HOURS particularly slapped cheek disease) due to a parvovirus You may have rubella on the cheeks infection may be the (German measles). cause in a child. Roseola infantum Pale pink rash on (a viral infection that trunk and/or face • Follow the advice causes high fever followed by a rash of None of for bringing down a tiny pink spots) is the above fever (p.164). another possibility, particularly in children ACTION under 4 years old. SEE YOUR DOCTOR • Follow the advice WITHIN 24 HOURS for bringing down a if you cannot identify fever (p.164). a possible cause for your rash and fever • Warn any contact from this chart. you think could be pregnant.
Do you have ACTION RASH WITH FEVER 97 any of the following? !DIAL 911 OR CALL EMS Checking a red rash You may have Severe meningitis (inflamed If you develop a dark red rash, headache membranes around check if it fades on pressure by Drowsiness the brain). pressing the side of a drinking or confusion glass onto it. If the rash is Dislike of ACTION visible through the glass, it bright light may be a form of purpura, a Neck pain when CALL YOUR DOCTOR NOW rash caused by bleeding from bending head tiny blood vessels in the skin forward This type of rash may either because blood vessels Nausea or be due to a severe are damaged or because of vomiting allergic reaction to a an abnormality in the blood. None of drug such as penicillin. Purpura can be caused by one the above It could also be the of several serious disorders, result of a blood including meningitis, and needs Have you disorder that causes prompt medical attention. Dial noticed any of bleeding into the skin. 911 or call EMS if you have a the following high fever, severe headache, symptoms in the • Stop taking any over- or any of the other danger past few days? signs listed opposite. the-counter medicines Runny nose but continue to take prescribed medication Cough unless advised to stop by your doctor. Red eyes Do you have ACTION None of a severe the above SEE YOUR DOCTOR sore throat? WITHIN 24 HOURS Yes You may have measles, which is a potentially No serious illness. ACTION • Follow the advice SEE YOUR DOCTOR for bringing down a WITHIN 24 HOURS fever (p.164). if you cannot identify ACTION a possible cause for your rash and fever SEE YOUR DOCTOR from this chart. WITHIN 24 HOURS You may have a viral illness, but scarlet fever is a possibility. • Follow the advice for bringing down a fever (p.164).
98 FAMILY ILLNESS Eye pain or irritation Injury, infection, and allergy are the most common ! Contact lens wearers causes of discomfort or irritation of the eye and If you wear contact lenses eyelids. A painless red area in the white of the eye is and experience any kind of likely to be a burst blood vessel and should clear up eye pain or irritation: without treatment. However, you should see your • Remove your lenses doctor if your eyes are sore. Consult your doctor without delay. immediately if your vision deteriorates. • Do not use them again until the problem has been Does either of ACTION identified and treated. If the pain is caused by grit under START the following TRY SELF-HELP MEASURES the lens, there is a risk that the cornea will be scratched. apply? A foreign object in • Make an appointment to your eye is likely to see your ophthalmologist. You have cause pain and redness. something in What is • Follow the first-aid the main your eye symptom? advice for dealing with You have a foreign object in the Pain in and injured your eye eye (p.36). around the eye Neither SEEK EMERGENCY HELP Itching or irritation of AT THE HOSPITAL the eyelid if a foreign object is Tender red embedded in the eye. lump on the Has your vision ACTION eyelid deteriorated TRY SELF-HELP MEASURES The eye since the injury? feels gritty You may have a stye Yes (infected hair follicle) None of or a chalazion (infected the above No gland in the eyelid). ACTION ACTION • Hold a clean, warm, !DIAL 911 OR CALL EMS CALL YOUR DOCTOR NOW damp cloth on the A serious eye injury eyelid for 20 minutes is possible. Expert Your pain may be several times a day. help may be needed caused by a minor eye to prevent permanent injury. CONSULT YOUR DOCTOR damage to the eye. • Follow the first-aid if your eye does not improve within 3 days. advice for dealing with eye wounds (p.35).
Is your vision Is your eyelid EYE PAIN OR IRRITATION 99 blurred? turned inward or outward? ACTION Blurred Eyelid turned MAKE AN APPOINTMENT Not blurred inward TO SEE YOUR DOCTOR ACTION Eyelid turned Entropion (turning outward inward of the upper or CALL YOUR DOCTOR NOW lower eyelid, or both) Appears normal is a possible cause of You may have acute your symptoms. glaucoma (painful, ACTION rapid rise in fluid ACTION pressure in the eye), SEE YOUR DOCTOR which could damage WITHIN 24 HOURS MAKE AN APPOINTMENT vision permanently. TO SEE YOUR DOCTOR You may have so-called ACTION cluster headaches or Ectropion (turning out uveitis (inflammation of the lower eyelid) is TRY SELF-HELP MEASURES of the iris), especially a possible cause of if the eye is red and/ your symptoms. You may have or watery. blepharitis (inflamed ACTION eyelid), especially if • Take an analgesic the skin is scaly and MAKE AN APPOINTMENT inflamed. such as acetaminophen TO SEE YOUR DOCTOR to relieve symptoms. • Relieve symptoms by You probably have • Rest in a quiet, conjunctivitis (inflamed holding a warm, damp membrane covering cloth on the eyelid. darkened room. the eye). • If you have dandruff Is there any • Wipe the discharge discharge from too, using an antifungal away from your eye shampoo will improve the eye? with clean, moist both conditions. cotton. Watery CONSULT YOUR DOCTOR discharge • Use artificial tears, if self-help measures Sticky discharge available over the do not help. counter, to relieve No discharge symptoms. ACTION ACTION MAKE AN APPOINTMENT TO SEE YOUR DOCTOR MAKE AN APPOINTMENT TO SEE YOUR DOCTOR if you cannot identify a possible cause for your You may have eye pain or irritation keratoconjunctivitis from this chart. sicca (dry eye), in which the eye fails to produce enough tears. • Use artificial tears, available over the counter, to relieve symptoms.
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