Christchurch Hall Surgery

20 Edison Road, Crouch End, London N8 8AE

Minor Illness Advice

THIS IS A BASIC GUIDE TO MINOR AILMENTS AND MINOR ACCIDENTS WHICH ENABLES YOU TO HELP YOURSELF IMMEDIATELY AND MAY ELIMINATE THE NEED TO ATTEND THE SURGERY.

CUTS, GRAZES AND BLEEDING

Wash the wound thoroughly with water and a little soap.  To stop bleeding apply a clean, dry dressing onto the wound and press firmly for about five minutes.  Never use a tourniquet! Cover with a dry dressing once the bleeding has stopped.

Seek medical attention if:

  • The cut is deep and the edges cannot be pulled together
  • You have a deep or dirty cut – you may need a tetanus booster
  • Severe redness or swelling develops after a few days, which may indicate infection
  • There is severe bleeding from the wound.

Nosebleeds are common and most are easily dealt with.  Sit in a chair and lean forward with your mouth open. Then pinch the nose just below the bridge for approximately ten minutes whilst applying ice packs to the nose.  Avoid hot drinks or hot food for 24 hours. If symptoms persist consult your GP.

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SPRAINS, STRAINS AND BRUISES

Think of “RICE” (rest, ice, compress, elevation). When the pain subsides (and this may take a few days), exercise the limb or joint gently to prevent stiffness.

Bruising takes several days to get better and become less painful. The mark on the skin will change from blue to purple or black and will fade to yellow after a few weeks before disappearing altogether.

Seek medical attention if:

  • Symptoms do not improve
  • Colour of bruising remains unchanged after a week
  • You think there may be a broken bone. In that event you should immobilise the limb with padding and seek aid immediately

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BACK AND NECK PAIN

Keep as active as you can.  Too much bed rest will cause your muscles to stiffen and lose strength.

You should apply warmth and massage the painful areas, and take a painkiller such as paracetamol or an anti-inflammatory such as ibuprofen.

Swimming or other gentle exercise is good for your back. Check that your posture is good.

Try to avoid being stressed.  Gentle relaxation exercises are useful.  Exercises to strengthen your stomach, back and side are very helpful in the long term. Physiotherapy usually resolves the pain. 

In the long term:  if you are overweight it is advisable that you lose weight.

Consult your GP if:

  • The pain continues for more than a week
  • The pain extends into one or both legs or arms
  • There are areas of numbness or tingling on your arms, buttocks, legs or feet
  • It is difficult to move a limb
  • Coughing or sneezing increases the pain
  • You do not have normal bowel or bladder control

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COLDS AND RUNNY NOSES

These are usually due to viral infections.

Colds start with feeling unwell, a headache, sniffing and a runny or blocked nose.  It usually resolves after a few days but in some cases the mucus from the nose changes from watery, clear mucus to thick and green.  Although children can have a fever, a temperature is not normally associated with a cold.  Because the nose is linked to the ears, sinuses and throat, the cold can spread there, this can result in middle ear infection, often with a fever.  The mucus can seep down the back of the throat, and an annoying dry cough may develop.  Other symptoms are sneezing, hoarseness, sore throat and a slightly raised body temperature.  These symptoms usually resolve without the use of antibiotics which are not effective against viral infections.

The cold will normally clear after 5-10 days.  In the meantime, unless you develop a fever, you may go out.  Keep your room well ventilated with the window open.  Avoid smoking and sleep with your head slightly raised.  Please remember that sneezing and coughing projects viral particles into the air which can infect other people in your family or in your household.

Aspirin or paracetamol are helpful, but you may have to take them for more than a week.  It is a good idea to gargle with salt water to relieve sore throats.  Do not give young children aspirin; use a combination of paracetamol syrup and ibuprofen syrup instead.

You should consult you GP if:

  • There is a high fever which lasts for more than four days
  • If nasal mucus becomes green or yellow, is accompanied by headache or a pain behind the eyes and lasts for over a week
  • If a baby continues to cry or refuses feeds for 48 hours.  The baby should be able to have fluids

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CYSTITIS

This is a common bladder infection which usually affects women more often than men. Women are more likely to get cystitis during pregnancy or after the menopause.

The symptoms are: feeling the need to pass urine frequently with a burning sensation at the end; a dull ache in the lower stomach; there is often fever; the urine can be bloodstained or cloudy and foul-smelling.

You should see your doctor if you think you have a bladder infection, but in the meantime you can take steps to relieve the symptoms. To prevent cystitis you should drink plenty of water, wipe from front to back after going to the toilet, wash you hands before inserting tampons, wash your genital area before and after sex and likewise wash them each morning and night and encourage your partner to do likewise.

To treat the condition:

Drink ½ litre (about three glasses) of water straight away, then ½ litre every 20 minutes until you are producing large amounts of urine.  This helps to flush out your bladder.

Cranberry juice has been known to relieve some symptoms.

Take a potassium or sodium citrate solution – available from your pharmacist. Alternatively, take a teaspoon of bicarbonate of soda in water every hour for the first three hours, and then three times a day.  If you are taking other medication or have high blood pressure or heart problems, check first with your doctor.

A hot water bottle held to your stomach or back can ease the pain.

Take simple painkillers like paracetamol or soluble aspirin.

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INFLUENZA

The symptoms are not dissimilar to a severe cold, and the treatment is the same.  Colds are more common, and less serious.  Influenza tends to last longer and can leave you feeling debilitated for several weeks.

Antibiotics are of no help - simple home remedies are the best treatment.

The first signs of the 'flu are a fever, chills and high temperature, headache, muscle and bone aches, and a dry cough.  Runny nose and sneezing may also occur.  If there is a chest or ear infection, a chesty cough and earache may occur.

If you are likely to be seriously affected by 'flu, or in the case of a baby or elderly person, you should ask the GP about immunisation.  Immunisation is also necessary for people with chest disorders like asthma or those with long-term heart disorder, diabetes or kidney disease.

The best way to treat the 'flu is to rest a home, do not exercise, drink plenty of non-alcoholic drinks, take paracetamol (children under 12 can be given a sugar-free paracetamol syrup), do not smoke, keep the bedroom warm but airy, sponge children if the temperature is high, and stay at home for several days until the symptoms have gone.

You should consult the GP if:

  • The fever is still there after four days
  • A child becomes listless and refuses fluids
  • There is wheezing when breathing
  • There is an earache with discharge from the ear
  • There is a productive cough with yellow or green sputum and high temperature
  • There are chest pains or shortness of breath

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FEVER

The normal body temperature is up to 37˚C (98.4F).  A raised temperature beyond this is considered a fever and is the body’s natural reaction to infection which it is fighting.  The body loses water through the resultant heat and sweating: this is called dehydration.  You should replace your fluid loss by drinking a lot of water or dilute fruit juice. Keep the room aired and at a comfortable temperature.  You could sponge your body down with tepid water and let it evaporate naturally.  This will lower your body temperature.

A fever which rises quickly in children may cause a febrile convulsion.  This is generally benign but you should always consult a Doctor afterwards.

Contact the GP if:

  • The fever lasts longer than 48 hours or returns
  • You feel listless
  • You have recently returned from the tropics or a hot country
  • In the case of a child if the fever is accompanied by a headache, particularly when the head is bent down, vomiting and a rash.
  • A baby’s fontanelle (soft spot on the top of the head) is tight or bulging
  • You have a temperature over 40˚C (104F)
  • You have a stiff neck or vomiting

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DIARRHOEA

This is increased bowel action with water loss occurring more than five or six times a day.  It can be associated with vomiting  and may be caused by viral or bacterial  infections.  It can also be caused by food which has not been prepared hygienically or has not been reheated properly.

It is advisable that the stomach should be allowed to rest and therefore no solid food should be consumed for at least 24 hours.  The patient should have only clear fluids (no milk). Taking oral dehydration salts (eg Dioralyte available from your chemist) is advisable if the diarrhoea and vomiting persist for over 48 hours.  This is especially important for young children and babies.  Formula milk should be stopped,  but breast milk is allowed.

As the condition improves, gradually introduce more solid (but without fat) food to the diet.  Simple grilled meat/fish and boiled potatoes and rice are advisable.

Remember to wash your hands after going to the toilet and always clean under the toilet seat.  You must not share cutlery, cups and glasses as the infection would be transmitted to other people sharing your household.

The contraceptive pill will not give full protection when you have diarrhoea.

You should contact your GP if:

  • You also have a high fever
  • You have recently returned from foreign travel
  • It persists for more than a week (or two days in children over one year old)
  • There is blood in the diarrhoea.
  • Babies become drowsy or confused, refuse liquids for a half a day,  are sick all the time, or have a fever

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HEADACHE

This is usually caused by stress, tension or dehydration but can come with a fever as part of influenza.  In this case simple pain relief, rest and fluids are very helpful.

There are severe headaches, known as migranes, that involve one side of the head and can come in attacks. These often start with visual disturbance followed by an intense headache.  Nausea and vomiting may occur. The patient feels better if they rest in a darkened room.  Specific anti-migraine medication is very effective.

Contact your GP if:

  • You think you are having migraines
  • A headache persists for longer than five days
  • It persists after other cold symptoms disappear
  • You are pregnant
  • You get a very bad headache suddenly with problems with your vision
  • You get a headache following an accident

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IRRITABLE BOWEL SYNDROME

IBS is usually associated with abdominal pains and bloating after a meal.  There is alternating of constipation or diarrhoea.  The cause is not known, but stress, diet and lack of regular physical activity may be involved.

A high fibre diet with whole grain bread, pasta, fresh fruit and vegetables can prevent the condition.  Try cutting out coffee, red meat and dairy products from your diet.  Cutting down smoking, taking time to relax and exercise may also help.

Try putting a hot water bottle on the sore area. 

You should consult your GP if:

  • The pain is acute.  He may prescribe anti-inflammatory tablets
  • The home treatment does not work
  • There is blood in the stools or they are black or covered in mucus

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NITS, HEADLICE OR PUBIC LICE

Lice are small insects from about an eighth to a quarter inch long.  Headlice are found close to the scalp, in the hair, where the female lays her eggs which look like tiny white pips.  The eggs stick to the hair.

Even the most careful hygiene cannot prevent you getting lice, so do not be ashamed of it.  They are usually introduced by hair to hair contact.

Pubic lice are another form of lice transferred through sexual contact.  They also live in beards or moustaches and other body hair.

It can take 1-2 weeks after infection before the itching commences.

Preparatory medications available at chemists should be used with the appropriate instructions.  Whilst a lotion can kill the eggs of nits and lice, dead nits often stay stuck to the hair unless combed out with a fine-tooth hair comb.

You should consult the GP if the condition does not improve after treatment.

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RASHES

Most rashes are generally harmless, and disappear in due course.  As a result of the standard vaccination programme, many children’s illnesses, for which a rash is the first sign, are now very rare.  Unfortunately there are illnesses for which there is no known vaccine.  Most of these are caused by a virus and can neither be prevented or treated.

Chickenpox

This manifests as blistery spots occuring mostly on the trunk.  These can spread inside the mouth and on the scalp.  They come out in crops every 4-6 hours.

Chickenpox is highly contagious until all the spots have become dry.  Patients are contagious for 10 days after the first crop of blisters have appeared

Roseola

This occurs mainly up to the age of three.  It starts normally with a high fever followed by a day without fever.  After that, small pink, rounded spots appear (starting with the face and spreading to arms and legs) and there may be a swelling of the glands in the throat.  This is harmless and cures itself.

Slapped Cheek Syndrome

Characterised by rosy red cheeks.  The rash then spreads to arms and legs, and can remain for several weeks.  Otherwise there are no serious symptoms.

Rubella (German Measles) and Measles

Thanks to vaccinations these are now very rare.  German Measles, however, which produces only a faint rash, is dangerous for pregnant women who have not been vaccinated or previously had the illness.

Fever, cough and watery red eyes accompany measles.  The rash follows about 36-58 hours after the initial symptoms, first showing behind the ears.  It is blotchy and red, becoming dirty brown in colour.

Hand, Foot and Mouth Disease

Epidemics of this disease occur every three years.  The rash is grey with small blisters usually found in the mouth, on the fingers, palm, soles, heels and buttocks.

With all the above you should prevent scratching because of the risk of infection and scarring.  Wash your hands and the child’s frequently, and cut your child’s nails very short.

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WORMS

Threadworms are very common in children.  You will see them in the stools and their bottom may be itchy.  They are passed on very easily.

Roundworms are very uncommon but may be caught from animals.  Wash your hands after going to the toilet, touching animals and especially before eating.

If you keep pets, de-worm them regularly.

Your pharmacist will give you a medicine to treat your family, but not for children under two.

Consult your GP if you are uncertain about a child's symptoms, you have stomach bloating or pain, or if you are pregnant or epileptic.

You should consult your GP if:

  • Your child is unwell
  • The fever returns or is present for 4-5 days
  • The rash is reddish-blue and does not disappear when a tumbler is pressed on it

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