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Last Updated:
23/02/06
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Bumps and Bruises .
Burns and Scalds .
Colds and Stuffy Noses.
Coughs.
Cuts and Grazes.
Cystitis.
Diarrhoea .
Earache.
Febrile Fits .
Flu.
Head Injuries.
Head Lice.
Indigestion.
Infectious Illness in Children .
Insect Bites and Stings .
Insomnia .
Nose Bleeds.
Raised Temperature.
Sickness.
Sore Throat.
Spots and Rashes .
Sprains.
Sunburn.
Threadworms .

Bumps and Bruises

Children are always falling over. They usually cry and may seem to be quite upset, even if they have not really hurt themselves much. Children are very resilient and usually do not injure themselves badly by falling over. If the child moves normally, it is unlikely that they have broken anything. Unless there is an obvious injury, a cuddle will help them feel better.

Bruises can be quite uncomfortable for several days and may take a few weeks to fade completely. The colour of the bruise is due to seepage of blood under the skin, and it will change colour as it fades. A bad bruise can be eased by placing a cold flannel over it, or a towel containing ice cubes. Paracetamol will ease any pain.


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Burns and Scalds

Minor burns and scalds cause redness of the skin. These can be treated at home if a small area is involved. More severe burns cause blistering. As soon as a burn or scald happens, the affected part of the body should be treated with cold water (e.g. under a running cold water tap).

If electricity is involved, you must turn off the power supply before you do anything - do not touch the patient if the power is still on - you will be electrocuted too.

You need to see the practice nurse immediately if the burn causes blistering, is large, or affects the face, or if the patient is a child. It is very important to keep children away from hot objects - including the iron, the oven door and hot drinks. Your health Visitor can advise you further on safety in the home.


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Colds and Stuffy Noses

The common cold is a virus infection. It causes stuffiness, sore throat, sneezing, catarrh, a temperature and makes you feel unwell. There is no specific treatment but you can try the following.....

You may need to visit a doctor if the patient is a small child or baby and seems unwell or is not feeding, or if you develop sinus pains or a rattling cough.


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Coughs

A cough is a very common symptom. It is the body's protective mechanism - if dust or food gets into the air passages, or mucus from a cold, coughing helps to clear the passages to prevent infection of the lungs.

The best treatment is inhalations (for children, try sitting in a steam-filled bathroom.) Cough linctus will help to soothe the cough.
Sometimes the cough is due to an infection further down in the lower air passages. If coughing persists for more than a week or two, or produces a green or yellow spit or blood, or if you wheeze, you should consult a doctor - also if there is pain on breathing (unless you have pulled a muscle while coughing).

In a child, a cough which occurs mostly at night or on running about may be due to asthma, which is very common and
is easy to treat.

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Cuts and Grazes

You can usually stop a cut bleeding by pressing on it for 2 - 3 minutes. It should be cleaned with antiseptic solution.If the cut is small, you can put a planter on it, bringing the edges of the cut together. Keep it dry for 4 - 5 days. If the cut is deep or the edges will not come together, consult the practice nurse.

Grazes often contain dirt or gravel and should be cleaned well with clean water or antiseptic solution.

Make sure the graze remains clean and dry, and it will form a scab, which will protect it while it heals over. The scab will fall off when it is ready - picking it off will only delay healing and allow infection in.

If a cut or graze becomes red or swollen, it is probably infected and will need some treatment.

If you have not had a tetanus injection in the last ten years, you will need a booster.

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Cystitis

Cystitis is very common in women. You feel discomfort when you pass water and sometimes you can have a stomach ache. You also tend to want to go more often, and in a hurry too!

The best thing you can do is to drink as much water as you can to keep the kidneys and bladder flushed through.

A warm hot water bottle over the lower stomach is soothing, and you can take some painkillers.

If the symptoms persist, you will need to see a doctor - be prepared to produce a sample of urine.

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Diarrhoea

Diarrhoea is common and unpleasant but usually gets better without any specific treatment. It can be caused by a dietary change, overeating, excessive drinking or foreign travel, but many attacks are caused by a virus.

Diarrhoea can be associated with cramping stomach aches or sickness. The best treatment is to stop eating for 24 hours and drink plenty of clear fluids (water or weak squash). Most attacks will settle quickly if you do this.

Children should be given rehydration sachets made up in water to give them sugar and essential salts.

If the diarrhoea does not settle, if the pain is severe, or if there is any blood with the diarrhoea you should consult a doctor.
Small children can get dry very quickly, especially if they are also being sick. If a baby or small child is sleepy or floppy or has fewer wet nappies, you should contact the surgery.


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Earache

Earache is very common, especially in young children. It is not always due to an ear infection - it can also be caused by a sore throat, toothache, pain from the jaw joint and even teething. It can also happen with pressure changes behind the ear drum (e.g. with congestion from a cold, or with aeroplane travel.)

Some children pull at their ears from habit or when they have a temperature. Try the following.....

Many earaches will get better in about 12-24 hours, but it is sensible to see a doctor if the earache continues or if the ear discharges.

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Febrile Fits

Occasionally a young child (usually under five) will have a fit with a high temperature. This is very frightening for the parents, but it is important to stay calm. Your child is not going to die and it does not mean that he is an epileptic.

During a fit, the child will twitch or shake all over, and will seem to be `not with it'.

Lie the child on his side so that he does not choke, and in a place where he cannot harm himself. The fit usually lasts less than 5 minutes.

Stay with him until the fit is over - the child will be still and probably unrousable for a while.

Do not attempt to put anything in the mouth.

Call the doctor when it is safe to move away from your child.

Try to cool him down by using simple methods such as washing him down with lukewarm (not cold) water, by ensuring that there is some fresh air circulating in the room, and that he is not wearing too many layers of clothing. Do not try to give paracetamol syrup or drinks until the child is conscious again.

Most children who have a febrile fit have a simple virus infection, and do not have another fit unless the temperature goes up again.

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Flu

`Flu' (influenza) is caused by a virus. The virus is very clever and tends to change its character each year to avoid the body's immune system - that is why you can catch flu each year.

Flu makes people feel very ill. The patient will have a high temperature, and feel hot and shivery, with aching limbs, a headache, and a dry cough, in fact they will feel awful.

There is no specific treatment for flu - stay in bed, drink plenty of fluids, and take paracetamol to help the temperature and the aching. Proper flu can last up to two weeks and does not respond to antibiotics. Occasionally, you can get a bacterial infection on top of the flu e.g. a chest infection, or an ear infection.

People who are elderly or have other illnesses such as chronic bronchitis, asthma, chronic heart or kidney disease, or diabetes, are especially prone to developing the `secondary' infections - that is why we recommend that these people have an injection each year to prevent them catching flu.

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Head Injuries

Knocks to the head often cause a lot of anxiety. If the person was knocked out, has double vision or can not remember what happened, they need to be seen by a doctor.

Children are sometimes sick after even a very minor bump to the head, but if the sickness persists, or if they become drowsy, or behave oddly, you must contact a doctor or go to casualty immediately.

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Head Lice

Head lice (or nits) are very common, especially in children. They prefer clean (rather than dirty) hair. They are transferred by contact, and can cause a very itchy scalp, which can become crusty and infected from scratching. The eggs can be seen as tiny dots attached firmly to the hairs.

Treatment is with special medicated shampoos available from the chemist, and all the family should be treated at the same time. Follow the instructions on the bottle.

Alternatively, the hair can be washed and conditioned and then while still very wet, combed with a fine-toothed comb (over a pale surface so that you can see any lice). If lice are seen, this combing should be repeated every 3-4 days for 2 weeks.

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Indigestion

This is a very common problem which can be very distressing. It is usually caused by a change of diet (e.g. a hot curry) or overeating or excess alcohol.

Simple indigestion can be cured by avoiding smoking, alcohol, tea, coffee, and acidic foods like fruit, and by having a milky drink or a dose of an antacid medication.

Persistent or recurrent indigestion can be due to a number of different problems, and needs to he discussed with the doctor.


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Infectious Illness in Children



There are certain virus infections which are more likely to affect children. Some of these (eg. mumps and measles) are now very uncommon because of the introduction of routine vaccination of babies and young children. It is recommended that you have your child immunised, because these infections can still occur in those who have missed out on their injections for various reasons.

In general, patients with an infection should keep away from pregnant ladies, the elderly and young babies.



Incubation Periods for Infectious Illnesses


The table below indicates the various incubation periods for some common infectious illnesses

Disease
Usual Incubation
Period (Days)

How long is it infectious

How long should you keep a child off school/playgroup
Notes
Chicken Pox
14-21
From one day before rash to six days after last crop of spots appear
At least 6 days after last crop of spots appear
Adults with chicken pox and any pregnant woman who has been in contact with chicken pox should consult their doctor
German Measles (Rubella)

14-21

A few days before symptoms start until a week after rash appears
A week after appearence of rash
Any pregnant woman who is in contact with Rubella should consult their doctor
Measles
7-15
A few days before rash appears until seven days after
A week after rash appears
Rare since the introduction of the MMR vaccine
Mumps
14-21
From seven days after exposure until it has gone (approx 10 days)
Until swelling has subsided
Rare since the introduction of the MMR vaccine
Whooping Cough
7-10
From seven days after exposure until 21 days after cough starts
Twenty one days from onset of cough
Still common because many children have not been vaccinated
Hand-foot-and mouth disease
3-5
2-3 days before rash occasionally for some weeks after onset
Until well. Presence of rash does not indicate infectivity
Usually only mildly unwell
Viral Gastroenteritis
12-48 hours
For up to 48 hours after vomiting and diarrhoea has stopped
For 48 hours after vomiting and diarrhoea has stopped
Very infectious

This table shows the incubtaion time (the time between being exposed to the infection and the first sign of the illness and the infectious period (the time during which the infection could be passed on to someone else)

 

Chicken Pox

The patient becomes unwell, and then the rash appears. The spots are red and raised, becoming fluid-filled blisters within a day or two. They can occur anywhere, and they tend to pop when scratched and to ooze. They can become very itchy. After a few days, the spots dry up and become small scabs, which eventually drop off.

The patient needs to drink plenty and take paracetamol. Calamine cream can help to soothe the spots and ease the itching.
You need to see a doctor if the child is very unwell, or has a bad cough or earache, or if the spots become infected.
Adults who get chicken pox can become very unwell and should see the doctor. If you are pregnant and develop chicken pox or are in contact with someone who has it, you should consult the doctor.


German Measles (Rubella)

Symptoms begin like a very mild cold, then a pinkish rash appears which is made up of very fine, small spots. It often starts on the face. The child is usually not very ill, and can be treated with paracetamol and given plenty to drink.

It can be very difficult to diagnose rubella and many rashes can look similar.

It is important to keep the child away from anyone who might be pregnant because there is a risk of severe and lasting harm to the unborn baby. If there has been contact within the infectious period, the pregnant lady should have a blood test to check that she is immune to rubella. (Most are, but it still needs to be checked.)


Hand, Foot & Mouth Disease

This is a virus infection which causes a rash made up of very tiny blisters on the palms, soles of the feet and in the mouth. The patient is not usually unwell and it is not at all serious.


Measles

Symptoms are like a bad cold and cough. A red blotchy rash appears on the 3rd or 4th day. The child can become very unwell and may have a very high temperature. The eyes can be red and sore.

Treatment is with paracetamol, and plenty of fluids. You should inform the doctor. The illness lasts about a week.

Measles, mumps and rubella can be prevented by the 'MMR' vaccine which is usually given at around 14 months old.


Mumps


The child is mildly unwell and then develops swelling under the jaw and up to the ear on one or both sides. This will go down after about a week.

Give plenty to drink and paracetamol if needed. There may be discomfort in or around the ear.

Measles, mumps and rubella can be prevented by the 'MMR' vaccine which is usually given at around 14 months old.

Whooping Cough (Pertussis)

This begins with a runny nose and dry cough. After 1-2 weeks, the cough gets worse and occurs in spasms of coughing which are followed by a gasp (or 'whoop'). This can go on for several weeks.

There can be complications of whooping cough, especially in small babies.

Older children and adults are usually less badly affected.

You should contact the doctor.

Vaccination against whooping cough is recommended for babies.

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Insect Bites and Stings


These are very common and cause itchy red or white bumps. Calamine cream or 1% hydrocortisone available from a pharmacist will relieve the itching. Sometimes the redness can spread, especially if you scratch the bite. Cold flannels and calamine should be applied.

If the problem persists or the swelling gets very large, you will need further advice. Wasp and bee stings tend to swell and hurt as well as itch. They can be treated the same way as insect bites. Remember to check that you have removed all of a bee sting.
A few people are allergic to wasp and bee stings and need to seek treatment urgently.

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Insomnia

There are many reasons why some people do not sleep well. Sometimes it is because they are anxious or worried, or are depressed, or in pain.

Nowadays, doctors try not to prescribe sleeping tablets if at all possible, because they can easily become addictive.

It is much better to try to 'teach' your mind and body to sleep properly. There are several things you can try yourself to help you get off to sleep.

Make sure you are warm and comfortable and not hungry (but not too full either!)

Have a window partly open so that air can circulate.

Do not drink tea or coffee after mid afternoon - caffeine is a very strong stimulant and will keep you awake. Have a milky drink before you go to bed.

Try not to watch T.V. before you go to bed - it makes your mind more active and then it is hard to relax.

Regular exercise will help you to sleep better, as well as making you generally more healthy.

It is sensible to develop a routine which you follow every night.

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Nose Bleeds


Nose bleeds are very common and often look alarming, but they can usually be stopped by pinching the soft part of the nose firmly whilst leaning forwards with your mouth open. You should press continuously for about ten minutes without letting go.
Once this has stopped the bleeding, you should be careful not to blow your nose or sneeze for the next 24 hours in case this starts the nose bleed again.

You should avoid hot food or drink for a few hours. If the bleeding does not stop, or the person is feeling faint, you should contact the doctor.

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Raised Temperature

People usually know if they have a high temperature (ie above the normal average of 37°c) - they feel hot or cold, sweaty or shivery, and unwell. Children may be miserable and not want to play, and look flushed and hot. Small babies may just be sleepy and not want to feed. There are several things you can do to help...


You need to ask for further advice if the patient is a child and is very unwell or sleepy (especially if they are very young) or if the temperature persists after you have tried all the suggestions above.

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Sickness

Vomiting is sometimes caused by a virus infection, but can also be due to overeating or alcohol. Children can be sick when they have a raised temperature, or an infection (e.g. ear infection). Treatment is as follows ......


You need to see a doctor if there is severe pain, if the vomiting persists, or if the patient is a small child who cannot keep down any fluids, is lethargic, hot or unwell.


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Sore Throat

Many sore throats are caused by a virus and will get better by themselves.

Try some simple remedies......


If the throat is still very sore after 4-5 days, or if it is very swollen (there may be spots or ulcers on the tonsils) you may need to ask a doctor for further advice.

Most sore throats will get better by themselves in about 5 days.

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Spots and Rashes

Rashes are very common, especially in children. Most rashes are caused by virus infections - some of them have names (e.g. chicken pox) but many are just nameless viruses.

Spots

Spots are local infections in the skin. Ordinary spots will go away if you leave them alone. Occasionally they
become very large and cause swelling and pain - they may then need some treatment, especially if they are on your face.

Boils

Boils are like small abscesses. They contain pus which often releases itself (the boil bursts). Once they have burst they tend to resolve themselves, but boils usually need antibiotics.

Impetigo

Impetigo is a very infectious rash, commonest in children. It spreads very easily on the body and to other people. It looks like a patch of spots, often with yellow crusts or oozing, and is sometimes red. This needs to be seen by a doctor. Washing hands is very important, to prevent spread by contact.

Warts

Warts are caused by the wart virus. They are mildly infectious on contact.

Verrucas are just warts on the bottom of the foot - they tend to grow inwards because of the pressure on them.

Warts and verrucas will go away eventually if you leave them alone. Sometimes they can be painful or a nuisance, so you may want to get rid of them. There are many liquids and creams available. These must be applied very carefully to avoid burning the surrounding skin. Just follow the instructions in the box. Please do not treat anything other than warts with the wart medications - if in doubt, see the nurse first.

Some practices are able to treat warts or verrucas using a special liquid nitrogen machine which freezes the wart. This treatment is suitable for children over 8 as it causes some discomfort.

Eczema

Eczema (pronounced 'exma') is very common at all ages. It can be due to a local reaction to something (e.g. perfume, bath salts, metal) or it can just appear. You will be more prone to having eczema if you have a family history of eczema, asthma or hay fever. The rash is itchy and can occur as raised bumps, dry scaly patches, or redness.

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Sprains

Sprains are common injuries and can be very painful. The injured part will usually swell up and look bruised. It can sometimes be difficult to tell if it is broken or not - if in doubt, consult the surgery.

A cold flannel or ice inside a towel will ease the pain and help prevent further swelling. The injured part should be rested until the pain goes a bit, and then it can be mobilised gently. Do not over use it too soon - it will only make it swell and hurt more.

A bad sprain can take several months to get completely better.

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Sunburn

Children burn very easily in the sun even a hazy sun can burn them - so keep them covered with a T- shirt and a hat, and use a strong suncream. If you or your children do get sunburnt, cover the area with after-sun lotion or moisturising cream and take pain killers as necessary.

If the skin is blistered, it will need a dressing, so you must see the nurse. You must not leave children in cars if the sun is shining - the inside of a car can become very hot, even in the shade.

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Threadworms

It is very common for a child (or adult) to get threadworms. They often complain of an itchy bottom and they will scratch especially at night. The worms can sometimes be seen around the bottom, or on the child's bowel motions - they look like tiny white pieces of cotton thread.

The person affected, and all of the family in the same house will need to be treated. The infection is passed on because the eggs get under the fingernails when the person scratches their itchy bottom - so the child should wear cotton pants which are hot washed each day, and you need to make sure that the whole family scrubs their fingernails every morning, before meals, and after going to the toilet.

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