Severe vomiting and diarrhea can be very serious, particularly in children and the elderly, who are more vulnerable to the accompanying risk of dehydration. The loss of circulating body fluid can lead to life-threatening shock if it is not replaced.
Causes
Likely causes of vomiting and diarrhoea include:food poisoning; viral infections such as gastroenteritis, and sensitivity to a new or unusual food. Vomiting alone can also accompany some medical conditions such as concussion and compression and other injuries.
Isotonic drinks
These drinks replace vital fluids and important minerals and sugars in the body. Available to purchase ready made, you can also make your own.
Add 1 tsp salt and 5 tsp sugar to 1 litre (2 pints) of water or diluted orange Juice
This drink should be taken in short sips as needed.
Nosebleeds are very common among children and many start spontaneously. Unless they are a direct result of an impact to the nose, the cause may not be known. Simple treatment whereby the blood is encouraged to clot is usually effective. The priority is to protect the casualty’s airway and to try and prevent blood from being swallowed.
Nosebleeds Causes
Facial and nasal surgery
A foreign body lodged in the nose
Nose picking
Allergic rhinitis
Upper respiratory infection
Sudden trauma to the nose, very cold or very dry air, fragile blood vessels, nasal sprays, strenuous exercise, or picking the nose cause most nosebleeds.
Nosebleeds Symptoms
Blood running from the nose.
Sensation of fluid in the back of the nose and throat.
Frequent swallowing.
First Aid – How to treat nosebleeds
Lean the child forward and encourage her to spit blood into a handkerchief or some other receptacle.
Pinch the child’s nose just below the hard part at its top and apply firm pressure for 10 minutes (this is the amount of time it takes for a clot to form). If the bleeding has not stopped after 10 minutes, apply pressure for two further periods of 10 minutes. If bleeding continues then take the child to hospital.
Once the bleeding has stopped, advise the child not to scratch, pick or blow her nose, not to drink hot liquid and not to exert herself, as all these activities can dislodge the clot and cause the bleeding to start again.
The general guidance for dealing with bites and stings is: to monitor airway and breathing; be prepared to resuscitate if necessary; to support and reassure the injured person; to offer relief with a cold compress; and to avoid infection by cleaning and covering the wound. In addition, there are some specific treatments that may be useful for certain types of bites and stings.
Ticks
Ticks are tiny bloodsucking creatures found in long grass that attach themselves to animals and humans firmly by embedding their mouthparts into the skin. Ticks cause discomfort and can transmit disease. Although simple to remove, great care should be taken as the mouthparts could remain in the skin if removed incorrectly. Use a flat-ended pair of tweezers or gloved fingers and grasp the tick at its head end, as close to the skin as possible. Using even pressure, pull the tick straight up, avoiding twisting and squeezing the tick’s body. Once it has been removed, clean and cover the bitten area.
Mosquitoes
Mosquitoes are found all over the UK and are small airborne insects. They feed on animals, including humans, by injecting a minute amount of anaesthetic and a chemical that stops blood from clotting and then sucking blood from their host until they are full. Unfortunately this can leave a small inflamed area that is uncomfortable but not life-threatening. This can be easily treated by a cold compress.
In many countries mosquitoes carry malaria, which can be fatal. Should you visit countries that have malarial areas, you must seek advice from your doctor on how to protect yourself and which antimalarial drugs are best suited to you.
Jellyfish
There are very few species of jellyfish that are poisonous in the waters around the UK. However, there are plenty overseas, and some do find their way to our coastal waters. Generally those that are poisonous have long tentacles that sway freely beneath their bodies and contain stingers that inject chemicals into anyone that should come too close. Although not normally fatal, they can cause extreme pain that leads to panic, especially in children, which can lead to further danger in the water.
These stings can be treated by calming the casualty and then applying alcohol or vinegar to the affected area for a minimum of 3 minutes or until the pain subsides.
Should the casualty suffer a severe allergic reaction, emergency medical aid should be sought.
Weaver fish
Weaver fish are found all around the UK but are particularly prevalent in some areas of the south coast. They are small fish that bury themselves at the very top of the sand, usually in shallows where they hunt. They have sharp spines on their dorsal fin that can inject poison into anyone who steps on them.
Although the pain is extreme, it can be quickly relieved by placing the affected area in a bowl of water as hot as the sufferer can stand for 20 minutes or until the pain subsides. Make sure you test the hot water with your elbow first because otherwise you may scald the skin.
If the casualty suffers a severe reaction, emergency medical aid should be sought.
Most minor wounds can be treated in the home without the need for further medical attention. First aid treatment can promote recovery and prevent infection. However, further medical advice should be sought if: there is a foreign body embedded in the wound; the wound shows signs of infection; the wound has the potential for tetanus and the injured person’s immunisation is not up-to-date; the wound is from a human or animal bite.
First Aid for treating minor wounds
If possible, wash your hands before treating the wound. Check that there is nothing in the wound. If the wound is dirty, clean it under running water. Pat dry with clean, non-fluffy material. Clean the wound from the centre out with gauze swabs or antiseptic wipes, using a fresh piece for each wipe. Cover the wound with an adhesive dressing to apply pressure and protect from infection. Elevate the wound if necessary to help control bleeding.
Check there is nothing embedded in the wound and clean and dry it.
Clean the wound with antiseptic wipes or swabs, then cover it with a dressing for protection and to apply pressure.
Raise the wound if necessary to reduce blood flow to the affected area.
If there is gravel or grit in the world
If there is loose debris on the wound this can be easily washed away with water or taken off by gently dabbing with clean gauze. lf there are small bits of debris embedded into the wound these should be treated as foreign bodies. Gently cover with a clean dressing and bandage the dressing into place, taking care not to press on the embedded debris. Raise the injured part if appropriate and seek medical advice.
Bruising
A bruise is the sign of an internal bleed. Usually caused by direct impact, bruises are sometimes painful but generally heal swiftly with little intervention needed.
A bruise goes through several changes in appearance as it heals and may not appear for some time, even days, after the accident. Initially, the injured part may be red from the impact; over time this may become blue as blood seeps into the injured tissue; as it heals it becomes brown and then fades to yellow.
Severe bruising can also be the sign of serious internal bleeding. If bruising is extensive and is accompanied by any of the following signs and symptoms assume that a serious internal bleed is present. Treat the injured person for shock and seek medical help.
Signs and symptoms of internal bleeding
Casualty is known to have had an accident (not necessarily in the immediate past)
Signs and symptoms of shock
Bruising
Boarding – this most commonly occurs where there is bleeding into the stomach area; the quantity of blood combined wirh the tissues swelling results in a rigidity to the tissues
Swelling
Bleeding from body orifices
Most bruises, however, are not serious. First aid can reduce pain and promote recovery from an uncomfortable bruise.
Treatment of minor bruising
Check for underlying injuries such as broken bones or sprains.
Apply a cold compress to the site of the bruise to reduce swelling.
Raise and support the injured part as appropriate.
Insect bites and stings are painful but there are no insects native to the UK that carry potentially fatal venom from a single sting or bite. Biting insects include mosquitoes and fleas; stinging insects include wasps and bees. Stings and insect bites are not usually serious unless there is an allergic reaction. Allergic reactions to stings from insects such as bees appear to be increasingly common and these can be life-threatening. Stings in the mouth or throat are also dangerous as the swelling they cause can block the airway.
Stings and bites
A sting is felt as a sudden sharp pain and appears as a raised white patch on a reddened area of skin. A bite is less painful and usually causes mild discomfort and skin inflammation.
Potentially life-threatening responses to stings and bites
Anaphylaxis
This is an allergic reaction to a substance with which the body is in contact. Bee stings are amongst the most common cause. Anaphylaxis can develop within seconds and can be fatal.
Multiple stings
While one sting is unlikely to cause problems on a major scale for an otherwise healthy adult, several stings may provoke a dangerous response.
Reaction to venom
Insects native to the UK are unlikely to cause problems for an otherwise healthy adult but dangerous insects may be found as pets in the UK or in everyday venues when on holiday overseas.
Stings to mouth and throat
Any sting to the mouth or throat should be treated with care as subsequent swelling may cause difficulty with breathing.
Signs and symptoms of a life-threatening reaction
Difficulty breathing
Swollen lips, tongue and throat
Blotchy skin
Casualty has felt a bite or sting (sometimes this may be described as a scratch)
Pain, swelling and reddening over the site of the bite or sting
First Aid Treatment
Monitor and maintain airway and breathing. Be prepared to resuscitate if necessary.
If the casualty is a known sufferer of anaphylaxis, he may have an auto-injector that contains life-saving medicine. Help him to find this as quickly as possible and, if necessary, help to administer it.
If the casualty is conscious, help into the most comfortable position (this will usually be sitting up).
If the sting was in the mouth, give the casualty an ice cube to suck or frequent sips of cold water.
Call an ambulance and explain what has happened, identifying the insect if possible.
Make an attempt to identify what the casualty has been bitten or stung by but do not put yourself at risk.
Ordinary bites and stings
Signs and symptoms
Reddening, pain and swelling over the site of the sting
Person has felt a bite or sting
Sting left in the skin (if from a bee)
First Aid Treatment
If you can see the sting, remove it by flicking with the edge of a piece of plastic such as a credit card, or with tweezers. Take care not to squeeze the poison sac at the end of the sting.
Wash the affected area to reduce the risk of infection entering the wound.
Apply a cold compress to the site to reduce pain and swelling.
Remove rings, watches or anything likely to cause a constriction if the area swells.
Advise the casualty to see a doctor if pain persists or there are any signs of infection.
Any injury that pierces the skin can become infected. Infection is caused by germs entering the body, either through the object causing the injury (for example a dirty knife) or from sources after the injury occurred. Cuts, burns, bites, stings and open fractures all carry with them a risk of infection.
Signs and symptoms of infection
If the following signs and symptoms develop after an open wound is inflicted, the injured person should seek immediate medical attention:
Increased pain
Swelling
Redness around the site of the wound
Discharge from the site
Unpleasant smell from the site of the wound
Red tracks from the site to the heart
Swollen glands
Failure to heal
First Aid – Treating an infected wound
Cover the wound with a sterile dressing and bandage into place.
Raise the injured part if possible, to reduce swelling and pain.
Seek early medical advice. Treat for shock if necessary.
Preventing infection
There are a number of things that you can do to reduce the risk of infection.
When time permits (for example for non life-threatening, less serious injuries), wash your hands thoroughly before treating an open wound.
Wear gloves if available.
Try to reduce direct contact with the open wound-for example, ask the injured person to apply pressure with her own hand if possible.
Cover injuries as soon as practicable.
Do not cough over injuries-turn away and cover your mouth.
Advise the injured person to check that her tetanus immunisation is up-to-date.
The word hysteria has come to mean the extreme behaviour exhibited at time of high emotion. This can be positive emotion, for example delight at a pop concert, or negative emotion, for example the shock of hearing bad news. Hiccups are caused by an involuntary contraction of the diaphragm, the muscle that separates the lung and stomach cavities. They are very common and although not serious can be irritating and tiring if an attack continues.
Signs and symptoms of hysteria
Screaming, shouting and uncontrollable crying
Hyperventilation (breathing too fast) this may lead to dizziness and or trembling
An apparent inability to move (the person may appear to be rooted to the spot)
Aggressive behaviour (the person may direct this towards himself)
First Aid for Treating hysteria
Although this type of behaviour may appear to be extreme, the affected person’s feelings are very real to him or her. Hysteria is often a common, and some would argue, healthy response to situations of high stress.
Speak to the affected person firmly but quietly. Do not shout at her.
Move the person away from onlookers as subconsciously she may be reacting to the crowd.
Encourage the person to focus on breathing. If she is suffering from the effects of hyperventilation, such as cramps in the hands or dizziness, hand over a paper bag and advise her to re-breathe her own exhaled air.
Stay with the person until she has recovered.
Check the person for injury or any underlying medical condition, and treat as appropriate.
Panic attacks are sudden instances of extreme anxiety accompanied by alarming physical symptoms such as chest pains, breathing problems, sweating, stomach pains, palpitations (awareness of an abnormally fast heartbeat), dizziness and faintness. The best way to treat this is to encourage the sufferer to stay calm and to remember that the attack will soon pass. Rapid, shallow breathing can be helped by breathing into a paper bag. Relaxation exercises can help a person reduce anxiety levels. If a person has frequent panic attacks, she should see a doctor.
Headaches have many causes. Often they can develop for no apparent reason or as a symptom of common illnesses such as flu. Sometimes they are an indicator of a more serious condition such as a head injury, stroke or other serious illness.
Symptoms of tension headaches
Sensation of a band tightening around the skull
Pain ranges in intensity
A throbbing sensation that pulses in time with the heartbeat
May be accompanied by eye or neck pain
First Aid Treatment
Help the person into a comfortable position in a quiet place. Consider remedies such as dimming the lights, cold compress, fresh air and sips of cold water.
Check for other signs and symptoms that may indicate a more serious condition and take action as appropriate. Seek urgent medical advice if: There has been a head injury, There are signs and symptoms of meningitis, The person appears confused, drowsy, or there is any fall in the level of consciousness.
Help the person to take her usual painkillers.
If the pain persists, seek medical advice.
Signs and symptoms of meningitis
Any combination of the following may be present:
Fever
Headache
Nausea or vomiting
Stiff neck (pain or difficulty in touching the chest with the chin)
Convulsions
Sensitivity to light
Rash (bleeding under the skin) which does not go away if a glass is pressed against it
In addition, in babies and young children:
The soft spot on the head (the fontanelle) may be stretched tight
There may be floppiness, lack of focus on surroundings.
Children are prone to putting objects into their nose, ears and mouth. If left for some time, such objects can cause infection that may result in permanent damage. Young children are also particularly liable to swallow small objects. These usually pass through the system and can be identified in the bowel movement as having safely moved through the body. Larger or sharp objects pose a greater risk of internal injury. If there are signs of difficulty breathing, the object may have gone down the windpipe rather than the tube to the stomach.
Foreign bodies in the ear
Signs and symptoms of a foreign body in the ear
Pain
Temporary deafness
Discharge
First Aid Treatment
Do not attempt to remove an object from the ear as you are likely to push it in further, causing more damage, particularly to the ear-drum. Reassure the child and take her to hospital.
Insect in the ear
Signs and symptoms of an insect in the ear
Very loud buzzing/ringing noise in the ear
Pain or discomfort
First Aid Treatment
Sit the child down and reassure him before giving treatment.
Lean the child’s head towards the unaffected side and pour tepid water into the ear with the aim of floating the insect out.
If this does not work, take the child to hospital as soon as possible.
Foreign bodies in the nose
The key priority with any object in the nose is the maintenance of a clear airway. If at anytime the object appears to be making breathing difficult, follow the procedures for choking and make a call for emergency help.
Signs and symptoms of a foreign body in the nose
Pain
Swelling
Discharge (if the object has been there for some time)
Breathing difficulties
A snoring sound on breathing
First Aid Treatment
Sit the child down, and reassure him.
Encourage the child to breathe through his mouth rather than his nose.
Do not attempt to remove the object as you may push it further in, causing more damage.
Take or send the child to hospital so that the object can be removed.
Foreign bodies in the eye
Small items stuck to the white of the eye can be very irritating but are usually easy to remove. If an item is embedded in the eye or is stuck on the coloured part of the eye (the iris), do not attempt to remove it. Cover the eye as appropriate and take or send the person to hospital for treatment.
Signs and symptoms of a foreign body in the eye
Irritation and/or pain
Watering and/or red eye
Blurred vision
First Aid Treatment
Sit the person down facing the light so that you can clearly see what needs to be removed.
Examine the eye by gently separating the eyelids with your finger and thumb. Ask the person to move the eye up and down and from left to right. Allow the person to blink.
If you can see the foreign body and it is not embedded or touching the coloured part of the eye, gently wash it out. Tilt the head to one side and run water through the eye, holding the eyelid open. Continue with this treatment for up to 30 minutes, allowing the person to blink regularly.
If washing does not work and the object is not embedded in the eye, try to remove it with a moist piece of clean material.
If you remain unable to remove the object take or send the person to hospital.
Swallowed objects
Signs and symptoms of a swallowed object
Ask the child or bystanders what happened, and look for other small objects around the child
Stomach pain
First Aid Treatment
If the object was very large, sharp or potentially poisonous (for example some kinds of battery), call an ambulance. If the object was small and smooth, take the child to a doctor or hospital as soon as possible.
Inhaled objects
It is possible for small and smooth objects to be inhaled into the lungs. This may cause difficulty breathing, particularly if the objects are porous and swell up on contact with body fluids. Small nuts are a particular risk, with the added concern that some people have a severe allergic reaction to them.
Signs and symptoms of an inhaled object
Choking noises which pass as the object moves into the lung
Hacking cough
Difficulty breathing
Ask bystanders what happened and look around for evidence of bags of nuts, sweets etc
First Aid Treatment
If the person is unable to take a breath, treat her for choking if necessary, encouraging coughing, giving back slaps, chest thrusts, then abdominal thrusts.
Call an ambulance as soon as possible and monitor breathing while waiting.
Reassure the person and try to find out exactly what was inhaled.
A person’s normal temperature is between 36-38°C (96.8-100.4°F). A fever is said to be when the temperature remains higher than this for some time. Most fevers are caused by infection, either infection associated with diseases such as flu, meningitis or chickenpox or with a local infection, for example following a bite or in an open wound. Most fevers pass with minimal risk but a temperature over 40°C (104°F) can indicate a serious infection and medical advice should be sought. High temperatures, particularly in young children, can cause febrile convulsions.
Taking a temperature
A raised temperature is a sign that the body is fighting off an infection. There are several types of thermometer that can measure the body’s temperature, one of the most accurate being a mercury thermometer, in which a narrow column of mercury expands in response to heat and moves up to a point on a clearly marked scale. Take a temperature on the forehead, in the mouth, under the arm or, if you have an appropriate thermometer, in the ear. Do not take a child’s mouth temperature if you are using a mercury thermometer – she may bite ir and swallow mercury, which is a poison.
Signs and symptoms of fever
Raised temperature
Pale skin (becoming red as the temperature rises)
Feeling shaky and shivery
Increasing aches, pain and headache as the temperature rises
First Aid Treatment
Make the person comfortable. Ensure that the surrounding air is cool (open a window or use a fan) and provide the person with cool flannels or sponges. Take care not to overcool.
Give the person plenty of cool drinks. Encourage the person to sip these slowly to prevent feeling sick.
Look for any other signs of infection, such as rashes or swollen glands, and seek medical advice if you are unsure of the cause or seriousness of the condition.
Enable the person to take her usual painkillers. Paracetamol acts as an anti-pyretic, which means that it will help reduce a fever as well as bring pain relief. Non-steroidal antiinflammatories (NSAIDS) such as Nurofen are good for bringing down fever. Children should take medicine appropriate for their age.
