Minor Ailements
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This document provides information on managing minor ailments through standing orders in the community. It discusses principles of managing minor ailments, classifications of minor ailments including general and systemic types, assessment and management of minor ailments, types of standing orders including institutional, specific and general, and provides examples of standing orders for treating common minor ailments like fever, diarrhea, burns, dog bites, fainting, injuries and more. The goal is to enable community health nurses to safely treat minor conditions based on standing orders in the absence of a doctor.
Minor Ailements
- 2. INTRODUCTION • Community health nurse is responsible to provide primary health care in the community • Treatment of minor ailments and emergencies is an important component of community health nursing • Nurse should be able to identify the signs and symptoms of a patient and treat them according to the standing orders • Minor ailments indicate slight illnesses and emergencies of smaller nature.
- 3. PRINCIPLES OF MANAGING MINOR AILMENTS ENSURE SAFE AND HEALTHFUL ENVIRONMENT TO THE PATIENT TREAT THE RISK / INJURED PERSON PROMPTLY TO PREVENT ANY POSSIBLE COMPLICATION IN CASE OF INFECTIOUS DISEASE, TAKE APPROPRIATE PRECAUTIONS TO PREVENT THE SPREAD OF INFECTION KEEP CONTINOUS WATCH OVER THE PATIENTS AND VITAL SIGNS DURING THE PERIOD OF CARE HELP THE PATIENT TO GET WELL SOON AS POSSIBLE AND IN HIS ADL
- 4. USE THE OPPORTUNITIES OF HEALTH EDUCATION DURING THE CARE ALWAYS REMEMBER THE LIMITATIONS IN PROVIDING THE TREATMENT OR FOLLOW THE PHYSICIANS INSTRUCTIONS HELP THE FAMILY MEMEBERS IN COPING WITH THE SITUATION AND PREPARE THEM FOR TAKING CARE OF PATIENTS AT HOME RESPECT THE BELIEFS OF PATIENT IN CASE OF SERIOUS CONDITIONS REFER THE PATIENT WITH OUT ANY DELAY
- 5. CLASSIFICATION OF MINOR AILMENTS • Minor ailments can be classified into two • 1. GENERAL MINOR AILMENTS :- it include common accidents and emergencies which need immediate first aid • In this category – injuries and falls , dog bite , burns ,high fever , heat stroke , diarrhea , fainting etc
- 6. Systemic minor ailments • EYE • EAR • EYE ACCIDENTS • FOREIGN BODIES • INFECTIONS • POOR EYE SIGHT • DRY EYES • NIGHT BLINDNESS • EAR ACHGE • FOREIGN BODY • OTTITS MEDIA • DISCHARGE • DEAFNESS
- 7. • RESPIRATORY TRACT • CVS • ALLERGIC RHINITIS • COMMON COLD • SINUSITIS • SORE THROAT • COUGH • DYSPONEA • CHEST PAIN • ASTHMA • HYPERTENSION • ANEMIA • RHD
- 8. • DIGESTIVE SYSTEM • TOOTH ACHE • STOMATITIS • SORENESS IN MOUTH • CONSTIPATION • DIARRHOEA • INDIGESTION • VOMITING • ABDOMINAL PAIN • INTESTINAL OBSTRUCTION • HAEMORRHOIDS
- 9. • URINARY SYSTEM • NEURO MUSCULAR SYSTEM • REPRODUCTIVE SYSTEM • BURNING MICTURATION • RETENTION OF URINE • URINARY INFECTION • RENAL STONES • HEAD ACHE • BACK ACHE • CONVULSIONS • EPILEPTIC FITS • DYSMENORRHOEA • HEAVY BLEEDING • SORES AND DISCHARGES • BREAST LUMP
- 10. MANAGEMENT OF MINOR AILMENTS • ASSESSMENT – Taking history - Performing quick physical examination • FINDING THE CAUSE , MAKING THE DIAGNOSIS AND PLANNING FOR CARE • PROVIDING TREATMENT AND NURSING CARE • EVALUATING THE CARE AND CONDITION OF THE PATIENT – If the outcome is successful , plan for follow up - If condition does not improve or serious signs – refer to hospital
- 11. STANDING ORDERS • Standing orders are directions and orders of specific nature . On the basics of these on the non availability of doctors nurses / health workers can provide treatment at home hospitals or health institutions and community • Should be followed in temporary basics / or in emergency situation
- 12. OBJECTIVES • Tomaintain the continuity of treatment of the patient • Toprotect the life of the patient / to resuscitate him • Tocreate the feeling of responsibility in the members of health team
- 13. USES • Providing treatment during emergency • Enhancing the quality and activity of the health services • Strengthening of primary health services in the community • Decentralization of health responsibilities • Developing the feeling of confidence and responsibility in nursing and other health worker • Protecting the general public from quacks
- 14. TYPES OF STANDINGD ORDERS • The authorized doctor and the registered community health nurse jointly releases standing orders Institutional SpecificGeneral
- 15. INSTITUTIONAL STANDING ORDERS • Standing order prepared with a view of the available resources , staff position and objectivity of hospital • Difference will be there b/w government and private hospitals
- 16. SPECIFIC STANDING ORDERS • Prepared for the trained medical personnel • Technical knowledge and special skills are required • These orders should compensate the need of a doctor • Such orders enhance the quality of CHN
- 17. General standing orders • Common man is expected to follow some SO • Eg – in case of diarrhoea – ORS PACKET
- 18. STANDING ORDERS FOR TREATMENT OF MINOR AILMENTS – FEVER • Examine the vital signs • Gather information about other symptoms accompanying the fever – head ache , nausea , vomiting , shivering cold running nose , allergy , skin infection , jaundice, fits , cough • Provide rest and light meal to the patient • Prepare blood slide to examine malaria parasite • Give paracetamol tab • Give lots of liquids to the patient • If the fever is more than 102 deg F – tepid sponge
- 19. Contd …. • Monitor the pattern of fever and wait for two days • If the fever is accompanying with rashes- isolate the patient • In case of delirium , convulsions , unconsciousness and hyperpyrexia accompanying the fever refer the patient to the hospital
- 20. HEAT STROKE • Person suffering should be kept in shade and in a well ventilated place • Note the vitals • Remove all clothes from the person and wrap in a wet sheet • If the patient is conscious give him cold water mixed salt and other cold drinks • Keep continuous observation over temp • As soon as refer to hospital
- 21. DIARRHOEA – GI SYSTEM • Monitor the symptoms of dehydration • If the dehydration is severe or the patient is in the state of shock – refer him to hospital • Provide ORS to the patient • Rice water , coconut water , lemon juice , light tea , banana should be given to the patient • If there is epidemic of diarrhea sample should be send for stool test • If cholera is prevalent immunization should be taken
- 22. Contd …. • Food and water should be protected • Notification should be done • People should be educated about the control of flies
- 23. BURNS - SKIN • Try to keep the burned body part immersed in water • Check the spread of burns • If the cloth has stuck to wound – DO NOT TRY TO REMOVE IT • Rings , bangles , shoes , belts and other tight fitting articles to be removed • Do not touch blisters unnecessarily • Assess the percentage of burns • Give primary treatment of shock if needed
- 24. Contd …. • Give ORS if patient is conscious and not vomiting • Provide analgesics if required • Refer patient to further treatment
- 25. DROWNING - RS • Loosen the clothes from chest • Make the person lie on his abdomen and get the water out of lungs • Resuscitate the patient immediately and send him to the health care centre / hospital
- 26. BITES - DOGBITE • Thoroughly wash the wound with soap and water • Use running water • Apply Betadine or tincture iodine • If the wound is excessive – check hemorrhage • Stitches should be done only after 24 hours • Give injection TT • Do not kill the dog and observe for 10 days • Send the patient for ARV therapy
- 27. SNAKE BITE • Make the person lie down • Don not allow to move • Find out the kind of snake • Tie tourniquet above the bite and continue to loosen it every half an hour • Make a cut of 1 cm length and ½ cm deep at the place of bite and try to absorb poison from the site ( there should not be any wound in the mouth of the person sucking )
- 28. CONTD … • Clean the place with salt solution / water or ice • Console the person and send to hospital
- 29. SCORPION BITE • Remove the sting and put ice on it , after thoroughly cleaning the place • Apply tourniquet above the place of bite and remove it after half and hour • Give analgesic tablets and also the sweetened milk to drink • If patient is in shock – send to hospital
- 30. FAINTING - CNS • Lie down the person .his head should be at a slight lower level than feet • If the person is sitting , keep the head bended b/w both the legs • Person should get fresh air • Once the person gain consciousness ask him to take deep breath and give him liquids to drink • If unconsciousness continue refer to hospital
- 31. INJURIES AND FRACTURES – SKELTAL • Clean the wound with soap and water • Apply the spirit around the place of wound • Apply Betadine solution and bandage the wound with sterile solution • Monitor the condition of the patient • Treat the patient for shock • Immobilize the fractured area • Give analgesic and TT
- 32. WOUND- SKIN • Wash the wound with clean boiled water and antiseptic solution • Apply spirit around the wound • Remove the foreign bodies present in the wound • Bandage the wound using Betadine • Give injection TT • In case the wound is large and need suture , or caused by bullet or weapon refer to hospital
- 33. Standing orders for MCH CARE • Give tablets to check vomiting and nausea in early stages of pregnancy • In case of toxemia of pregnancy , advice her restricted salt diet and complete rest • Send to hospital if there is edema/ APH / PPH • If the mother develop fever after delivery try to ascertain the cause • Keep newborn in proper warmth • Initiate breast feeding
- 34. Convulsions in children • Lie down the child safely on a bed • Loosen the clothes from the chest and let the fresh air come • Clean the secretions from his mouth and let the respiratory tract function properly • In case of fever give cold sponge • Evaluate the cause
- 35. HEMORRHAGE • Lie down the person on back • Take BP • Press a pad on the site of bleeding • Give him liquids • Try to find out the cause of bleeding • Monitor the state of shock and in case of bleeding or condition of shock getting out of control send the patient for further treatment
- 36. Unconsciousness • Lie down the person in a well ventilated area • Remove dentures • Clean the secretions from mouth • Loosen the clothes from neck , chest and waist • Provide artificial respiration in case of blocked breathing • Try to find out the reason
- 37. SORE THROAT - RS • Record vitals • Inspect for white patches – if yes its s/s of diphtheria – need hospitalization • Take throat swab • If pharyngities – saline gargle • Give aspirin tablets • Advice honey syrup with lemon juice and hot water • If history of recurrent illness need surgery
- 38. Cough - RS • Find out the duration , type , color and consistency of sputum , weight loss etc • If TB is suspected refer to hospital for investigation • Advise rest • Give aspirin tablets • Give steam inhalations
- 39. INFLAMMED EYES / EYE DISCHARGE • Bathe eyes with water and clean with cotton swab • Apply sulphacetamide eye drops • Demonstrate cleaning and application of eye ointment • Cover with sterile eye pad and bandage • Refer if vision diminishes • Infection that is not responding to treatment or • Wounds / injuries
- 40. EAR ACHE AND DISCHARGE • Clean the ears • Apply sulphacetamide ear drops • Give analgesics , if not coming down refer • If discharge is present clean with boric acid and apply ear drops • If s/s not subsiding refer
- 41. TOOTH ACHE - GI • If tooth ache with out fever give potassium permanganate solution mouth wash tds • If with fever aspirin 5 gms for children and 10 gms for adults • Advise dental care • Encourge to eat amala , orange , lemon , guava ,, sprouted gram ,tomatoes , raggi and bajra • Ask patient to chew a clove with affected teeth
- 42. CONSTIPATION – GI • Advise more fluids . Leafy vegetables • Discourage laxatives and purgatives
- 43. ANEMIA – BLOOD DISORDER • Encourage to eat ragi, GLV • Advise dry fruits • Advise oral iron supplements • Get the stool examined for hook worms
- 44. Bleeding nose • Make patient sit with head erect and bend forward • Loosen all clothes at neck • Ask the patient to pinch nose at the junction of hard and soft palate • Don’t let to blow the nose • Check vitals • Apply cold compress • Refer to hospital
- 45. ROLE OF CHN • History collection / assessment • Finding out the actions/ complications and any specifications • Vitals monitoring • Identifying the needs and problems • Nursing services under standing orders • Implementing referral system • Informing authorities – out break of diseases • Keeping medicine kit ready • Representing nurses view point in meting • Being careful about limits • Ensure safe and healthy environment