Common complaints :::
Children are exposed to infectious diseases throughout their childhood. Most infections are caused by a virus, which cannot be treated by antibiotics. But if an infection is thought to be caused by bacteria, the doctor may prescribe antibiotics for the child. Often it is difficult to make the distinction between viral and bacterial infections on clinical examination alone.
Paracetamol (eg Calpol), in an appropriate dose, remains a very good treatment to relieve pain and fever in most circumstances. Ibuprofen (eg Nurofen for children) is an alternative for other than very young children, but should be avoided in asthmatics. Aspirin (eg Disprin) should never be given to children aged under 16 years unless prescribed by a doctor.
How to get a child to take their medicine :::
It may be difficult to get children to take their medicine. This might be due to a variety of reasons, but commonly stems from the child not liking the taste of the medicine, or having difficulty swallowing it. To get around this a wide variety of preparations of medicines are often available. Medicine may be found as drops, mixtures, liquids, powders, granules, suppositories, capsules and tablets with or without coating.
The first time a child has to take medicine, it may be a good idea to consult the doctor or pharmacist to decide which type of medicine the child is most comfortable with.
Medicine for small children :::
Mixtures, liquids and drops with flavoured additives of some kind are often the types of medicine preferred by small children. Often you can mix the medicine with juice or breast milk, but it is important to be sure that the child gets the exact amount of prescribed medicine; neither more nor less. Always follow the instructions given with the medicine and ask your pharmacist for advice if you have problems.
The dose for young children may sometimes be too small to measure using a spoon, in which case you will be given an oral syringe to administer the medicine. Make sure you know what to do before using it.
Medicine for chronically sick children :::
Some children suffer from a chronic (long-term) disease such as epilepsy or asthma and so constantly need medicine. They should be able to help choose the type of medicine they prefer. Most children handle these problems very well, as long as it is explained to the child why it is necessary to take the medicine.
At every age medicine is absorbed differently by the human body. Some medicines have very strong effects on children compared with adults, and vice versa. So different guidelines may be found concerning the correct dose of medicine, depending on the child's age and weight.
Safety and medicine :::
Never give a child any medicine without first checking the directions thoroughly. Even an innocent headache tablet may have unfortunate side effects. In some cases, it may conceal a disease or symptoms of a disease, which may delay the proper treatment.
The use and storage of medicine in the home is very important. Far too many cases of poisoning happen because of children's natural curiosity. They are interested in trying the types of medicines that adults have left in the bedroom, the bathroom or the kitchen.
Always remember to keep all medicine out of children's reach.
Based on a text by Dr Per Grinsted
Saturday, March 8, 2008
Diarrhoea :::
What is diarrhoea?
Diarrhoea is the passing of increased amounts (more than 300g in 24 hours) of loose stools.
It is often caused by a virus or bacteria and can be acute (short term) or chronic (long term) - lasting more than two to three weeks.
Most people are affected by diarrhoea at some time in their lives. It is often accompanied by stomach pains, feeling sick and vomiting. It is usually due to consumption of drinking water contaminated with bacteria, undercooked meat and eggs or inadequate kitchen hygiene - in other words, an infection.
Diarrhoea normally only lasts for a few days, but it can be very stressful when it occurs.
Globally, seven children die of diarrhoea every minute, mainly due to poor quality drinking water and malnutrition, which still affects the majority of the world population.
What causes diarrhoea?
* Diarrhoea is mainly caused by bacterial and viral infections and food poisoning.
* Diarrhoea can also be caused by bacteria or viruses that have been transmitted from person to person. For this reason, it is important to wash your hands with soap and water after using the toilet.
* You cannot assess the quality of food or detect contamination by its smell or the way it looks. Food which is 'off' might be obvious but contaminated food usually looks and tastes fine.
Diarrhoea occurs when the micro-organisms irritate the mucous membrane of the small or large intestine resulting in an abnormally large quantity of water in the motions. The irritated gut becomes very active, contracting excessively and irregularly (colic). This can be accompanied by nausea, vomiting, and cold sweats. In some cases the motions may include some blood.
Food poisoning
Certain bacteria (usually staphylococci) irritate the digestive tract by producing toxins. These toxins affect the mucous membrane much sooner, a few hours after consumption, compared with bacterial infection. For this reason, people with inflammation or sores on their hands should not prepare food for others.
Other causes
When taking antibiotics, many people suffer diarrhoea, which may continue after the antibiotic course has finished. The diarrhoea occurs because the antibiotic alters the intestinal bacterial environment. It is not an allergic reaction. In rare cases it requires medical treatment.
Chronic diarrhoea
Chronic diarrhoea can be a symptom of many disorders:
* irritable bowel syndrome
* acute, recurrent or chronic intestinal infections
* chronic intestinal inflammation (ulcerative colitis and Crohn's disease)
* chronic pancreatitis, which produces fatty stools
* laxatives
* lactose intolerance
* improper diet (consumption of too much alcohol, coffee or sweets)
* metabolic disorders such as diabetes and thyrotoxicosis
* intolerance to gluten (wheat protein).
What are the symptoms of diarrhoea?
* Frequent, watery motions.
* Loss of appetite.
* Nausea, vomiting.
* Stomach pains.
* Fever.
* Dehydration.
If the diarrhoea lasts more than three weeks, it is considered chronic.
What are the warning signs?
* Blood in the motions.
* Pus in the motions (yellow mucus).
* Inability to drink liquids because of vomiting.
* Dehydration - symptoms include excreting small amounts of dark urine, drowsiness, dry mucous membranes and thirst. Dehydration as a result of diarrhoea is a particular risk for young children and the elderly.
* Pronounced drowsiness due to dehydration or intoxication.
* Acute diarrhoea in infants.
* Acute diarrhoea in very old people.
What can be done at home?
* In cases of acute diarrhoea it would be wise to drink more fluids (3-4 litres a day), preferably containing sugar and salts. Ready-mixed rehydration sachets (eg Dioralyte, Rehidrat) can be bought from the pharmacist and added to drinking water.
* A sufficient intake has been obtained when the urine becomes light yellow in colour.
* Eat something containing salt, such as crisps or soup.
* Maintain good standards of hygiene.
* Eat normally as soon as your appetite returns but if you have suffered an acute attack of diarrhoea, avoid foods containing milk for a couple of days.
When should the doctor be consulted?
* When one of the warning signs outlined above is present.
* When the diarrhoea has occurred during or following a trip abroad - travellers' diarrhoea.
* When the diarrhoea has lasted more than one to two weeks.
How is diarrhoea treated?
Diarrhoea can usually be treated safely 'at home' and normally goes away by itself within a week. Treatment with antibiotics is therefore rarely needed, and may cause side effects, such as chronic diarrhoea.
Antidiarrhoeal agents, such as loperamide (eg Imodium), may be used, except in cases where there is blood or pus in the motions or if the diarrhoea is accompanied by high fever.
It has not been proven that freeze-dried lactic acid bacteria can prevent travellers' diarrhoea.
During visits abroad, boil all drinking water, or drink water from sealed bottles only. In addition, you should only eat vegetables that have been boiled or peeled and avoid ice-cream and salads (which may have been washed with unclean water).
Based on a text by Dr Torben Nathan, Dr Carl J Brandt and Dr Ove Schaffalitzky de Muckadell, professor of internal medicine
Diarrhoea is the passing of increased amounts (more than 300g in 24 hours) of loose stools.
It is often caused by a virus or bacteria and can be acute (short term) or chronic (long term) - lasting more than two to three weeks.
Most people are affected by diarrhoea at some time in their lives. It is often accompanied by stomach pains, feeling sick and vomiting. It is usually due to consumption of drinking water contaminated with bacteria, undercooked meat and eggs or inadequate kitchen hygiene - in other words, an infection.
Diarrhoea normally only lasts for a few days, but it can be very stressful when it occurs.
Globally, seven children die of diarrhoea every minute, mainly due to poor quality drinking water and malnutrition, which still affects the majority of the world population.
What causes diarrhoea?
* Diarrhoea is mainly caused by bacterial and viral infections and food poisoning.
* Diarrhoea can also be caused by bacteria or viruses that have been transmitted from person to person. For this reason, it is important to wash your hands with soap and water after using the toilet.
* You cannot assess the quality of food or detect contamination by its smell or the way it looks. Food which is 'off' might be obvious but contaminated food usually looks and tastes fine.
Diarrhoea occurs when the micro-organisms irritate the mucous membrane of the small or large intestine resulting in an abnormally large quantity of water in the motions. The irritated gut becomes very active, contracting excessively and irregularly (colic). This can be accompanied by nausea, vomiting, and cold sweats. In some cases the motions may include some blood.
Food poisoning
Certain bacteria (usually staphylococci) irritate the digestive tract by producing toxins. These toxins affect the mucous membrane much sooner, a few hours after consumption, compared with bacterial infection. For this reason, people with inflammation or sores on their hands should not prepare food for others.
Other causes
When taking antibiotics, many people suffer diarrhoea, which may continue after the antibiotic course has finished. The diarrhoea occurs because the antibiotic alters the intestinal bacterial environment. It is not an allergic reaction. In rare cases it requires medical treatment.
Chronic diarrhoea
Chronic diarrhoea can be a symptom of many disorders:
* irritable bowel syndrome
* acute, recurrent or chronic intestinal infections
* chronic intestinal inflammation (ulcerative colitis and Crohn's disease)
* chronic pancreatitis, which produces fatty stools
* laxatives
* lactose intolerance
* improper diet (consumption of too much alcohol, coffee or sweets)
* metabolic disorders such as diabetes and thyrotoxicosis
* intolerance to gluten (wheat protein).
What are the symptoms of diarrhoea?
* Frequent, watery motions.
* Loss of appetite.
* Nausea, vomiting.
* Stomach pains.
* Fever.
* Dehydration.
If the diarrhoea lasts more than three weeks, it is considered chronic.
What are the warning signs?
* Blood in the motions.
* Pus in the motions (yellow mucus).
* Inability to drink liquids because of vomiting.
* Dehydration - symptoms include excreting small amounts of dark urine, drowsiness, dry mucous membranes and thirst. Dehydration as a result of diarrhoea is a particular risk for young children and the elderly.
* Pronounced drowsiness due to dehydration or intoxication.
* Acute diarrhoea in infants.
* Acute diarrhoea in very old people.
What can be done at home?
* In cases of acute diarrhoea it would be wise to drink more fluids (3-4 litres a day), preferably containing sugar and salts. Ready-mixed rehydration sachets (eg Dioralyte, Rehidrat) can be bought from the pharmacist and added to drinking water.
* A sufficient intake has been obtained when the urine becomes light yellow in colour.
* Eat something containing salt, such as crisps or soup.
* Maintain good standards of hygiene.
* Eat normally as soon as your appetite returns but if you have suffered an acute attack of diarrhoea, avoid foods containing milk for a couple of days.
When should the doctor be consulted?
* When one of the warning signs outlined above is present.
* When the diarrhoea has occurred during or following a trip abroad - travellers' diarrhoea.
* When the diarrhoea has lasted more than one to two weeks.
How is diarrhoea treated?
Diarrhoea can usually be treated safely 'at home' and normally goes away by itself within a week. Treatment with antibiotics is therefore rarely needed, and may cause side effects, such as chronic diarrhoea.
Antidiarrhoeal agents, such as loperamide (eg Imodium), may be used, except in cases where there is blood or pus in the motions or if the diarrhoea is accompanied by high fever.
It has not been proven that freeze-dried lactic acid bacteria can prevent travellers' diarrhoea.
During visits abroad, boil all drinking water, or drink water from sealed bottles only. In addition, you should only eat vegetables that have been boiled or peeled and avoid ice-cream and salads (which may have been washed with unclean water).
Based on a text by Dr Torben Nathan, Dr Carl J Brandt and Dr Ove Schaffalitzky de Muckadell, professor of internal medicine
Coughing :::
Coughing is a reflex action started by stimulation of sensory nerves in the lining of the respiratory passages - the tubes we use to breathe.
When a person coughs, there is a short intake of breath and the larynx (the voice box) closes momentarily. The abdominal and chest muscles used for breathing contract, which in turn increases the pressure needed to drive air out the lungs when the larynx re-opens.
The resulting blast of air comes out at high speed, scrubbing and clearing the airway of dust, dirt or excessive secretions. Coughing is a common symptom when the airways are 'tight', as in asthma.
The cough reflex is a vital part of the body's defence mechanisms. Normally, the lungs and the lower respiratory passages are sterile. If dust or dirt get into the lungs, they could become a breeding ground for bacteria and cause pneumonia or infection in the breathing tubes.
What causes coughing?
Coughing usually means there is something in the respiratory passages that should not be there. This can be caused by breathing in dust particles in the air or when a piece of food goes down the wrong way.
It could also be a sign that an infection in the lungs is making the respiratory passages produce phlegm.
Coughing can be provoked by:
* the common cold, which is a frequent cause of acute cough that usually settles in less than three weeks.
* sucking material into the breathing tubes from your mouth.
* more severe illnesses, such as pneumonia, acute heart failure or pulmonary embolism (a clot in the blood vessels of the lung).
* smoking, which often causes chronic cough (smoker's lung).
* asthma - particularly in children who may only cough and show no wheezing.
* stomach acid coming back up the gullet and spilling over into the windpipe (gastro-oesophageal reflux).
* medicines used in heart disease called angiotensin converting enzyme (ACE) inhibitors.
* bacterial or viral infections in the lungs, eg acute bronchitis, pneumonia, whooping cough, croup in children
* rarely coughing can be provoked by psychological illness
* damage to the nerves that supply the vocal chords (known as vocal chordpalsy) and chronic cough can occur.
Coughing is more efficient when preceded by a full intake of air.
For this reason, patients with weak muscles, poor coordination of airway closure and re-opening, or who have airflow obstruction (as in COPD) will have a poor cough and be susceptible to complications including infection in the lower respiratory tract and pneumonia.
How can coughing be treated?
Coughing is a symptom, not a disease. It is the underlying cause of the cough that needs to be treated.
You should consult your doctor if any of the following symptoms accompany a cough, so that possible underlying causes can be investigated and treated where necessary:
* coughing up phlegm that is green, rusty brown, yellow, blood-stained or foul smelling.
* chest pain.
* shortness of breath or wheezing.
* pain and swelling in the calf.
* recurrent night-time cough.
* whooping cough or croup.
* worsening smoker’s cough.
* sudden weight loss.
* fever and sweating.
* hoarseness of the voice with a chronic cough that doesn’t clear up spontaneously.
If you can't cough but need to, problems soon arise. Equally, when coughing is painful (for example, because of a broken rib), patients try not to cough and this can be dangerous.
Ineffective clearance of the airway can lead to a chest infection and possible pneumonia. In these circumstances, pain-relieving medicine can be useful to permit an efficient cough.
Airways infection
Infections in the breathing tubes can be caused by both bacteria and viruses, although the most common cause in children is a virus. Bacterial infections can be treated with antibiotics, but viral infections cannot.
Vaccination has greatly diminished the incidence of whooping cough (pertussis), but if this is the diagnosis, antibiotic treatment with a macrolide antibiotic such as erythromycin decreases the severity of this illness within the first week of treatment.
Asthma
Asthma may cause coughing without wheeziness. This tends to be worst through the night, disturbing sleep. It may be the first sign of asthma in children, or a warning sign that asthma is worsening or not controlled properly. Conventional asthma treatment with inhaled anti-inflammatory preventative medicines and relievers will usually relieve a cough that is due to asthma.
However, a metered-dose inhaler may itself induce cough, and you may need to use a large volume spacer device or a dry powder inhaler instead.
Gastro-oesophageal reflux
Gastro-oesophageal reflux requires treatment with antacids to neutralise the stomach acid, or H2 antagonists or proton-pump inhibitors to reduce the production of stomach acid.
Smoking
Giving up cigarettes will lessen or abolish smokers' cough in 94 per cent of people within four weeks.
ACE inhibitors
If an ACE inhibitor is the cause of coughing, switching to alternate treatment such as an angiotensin II receptor antagonist will help.
How effective are cough medicines?
In cases where a cough is particularly annoying, but not life-threatening, a simple cough mixture may be useful. There are a range of over-the-counter medicines that can be helpful in such circumstances.
Taking these can be justified when there is no special reason to suspect any serious underlying disease, such as the symptoms listed above. You should ask your pharmacist for advice on which of the many available over-the-counter cough remedies are suitable for you.
A productive, chesty cough, in which phlegm is coughed up, should be treated with an expectorant cough mixture to help loosen the phlegm and make it easier to cough up from the airways. Expectorants contain ingredients such as guaifenesin, ipecachuana or ammonium citrate.
A non-productive, dry, tickly or irritating cough, in which no phlegm is coughed up can, be treated with a cough suppressant to reduce the cough reflex. Cough suppressants include pholcodine, dextromethorphan and codeine. Other cough suppressants include simple linctus, glycerin and lemon and honey, which coat and soothe the back of the throat.
Antihistamines such as diphenhydramine and promethazine reduce the cough reflex and also dry up nasal secretions, which can be useful for coughs that are caused by a postnasal drip (mucus running down the back of the throat), or are associated with a cold.
Ipratropium bromide nasal spray also reduces watery nasal secretions that can cause postnasal drip and contribute to a cough.
Some cough remedies also contain sympathomimetics such as ephedrine, for their airway relaxing and decongestant effects, and can be useful if you have a blocked nose as well as a cough.
Patients should not treat themselves with cough mixture for any longer than two weeks. If the cough persists, a visit to the doctor is definitely required - informed medical assessment will help identify the underlying cause and allow treatment.
What if a young child has a cough?
Older children and adults usually have some idea whether their cough is caused by a foreign body, dust or smoke particles, or an infection in the breathing tubes. Clinical inspection will reveal features that may suggest a specific cause.
If a young child coughs, parents need to be able to tell whether the cough is a sign of disease or whether their child has a foreign body in their respiratory passages.
* If your child also has a fever or a cold, the cough is a sign of an infection. If nothing else seems to be wrong, wait for the cough to go away. If the coughing goes on for more than a couple of days, consult a doctor.
* If the coughing comes on suddenly, and is very forceful, it's likely your child has swallowed something that's causing the cough. This could be life-threatening for your child, who could choke. Lift your child by the legs so their head points downwards, then slap their back with a cupped hand. If this doesn't help, call an ambulance immediately.
* If at any point your child seems very ill, you should consult an emergency doctor immediately.
Diagnostic testing for chronic cough
If you suffer from a chronic cough, tests will need to be carried out to determine the cause.
* After initial assessment, a chest X-ray is taken to ensure that serious diseases such as lung cancer or tuberculosis (TB) are unlikely.
* Blood and skin tests are of little help, although they may reveal an allergic tendency.
* Sputum (phlegm) examination for bacteria, TB and cancer cells can be ordered, together with non-invasive heart tests such as an ECG or even echocardiography.
* In difficult cases, further tests can be considered, including fibre optic bronchoscopy, CT examination of the chest and sinuses and even methacholine inhalation challenge or oesophageal pH monitoring. These are only available in special centres.
Whether a particular factor is responsible for chronic coughing can be determined when treatment for a specific cause achieves some benefit for the patient.
But often there is more than one cause for the cough, in which case treating only one factor will not succeed in completely relieving the symptoms. This is frustrating for both you and your medical adviser.
In such a case, a progressive and incremental approach is appropriate. Treatment directed at a specific cause is started and the result assessed.
If there is a partial but incomplete response, other treatments are then tried in turn. Eventually, the vast majority of coughing can be successfully managed in this manner.
If treatment is fruitless with no realistic chance of working - for example in the case of advanced lung cancer, the use of powerful cough suppressants may be justified.
Based on a text by Dr Ole Davidsen, specialist
source : NetDoctor
When a person coughs, there is a short intake of breath and the larynx (the voice box) closes momentarily. The abdominal and chest muscles used for breathing contract, which in turn increases the pressure needed to drive air out the lungs when the larynx re-opens.
The resulting blast of air comes out at high speed, scrubbing and clearing the airway of dust, dirt or excessive secretions. Coughing is a common symptom when the airways are 'tight', as in asthma.
The cough reflex is a vital part of the body's defence mechanisms. Normally, the lungs and the lower respiratory passages are sterile. If dust or dirt get into the lungs, they could become a breeding ground for bacteria and cause pneumonia or infection in the breathing tubes.
What causes coughing?
Coughing usually means there is something in the respiratory passages that should not be there. This can be caused by breathing in dust particles in the air or when a piece of food goes down the wrong way.
It could also be a sign that an infection in the lungs is making the respiratory passages produce phlegm.
Coughing can be provoked by:
* the common cold, which is a frequent cause of acute cough that usually settles in less than three weeks.
* sucking material into the breathing tubes from your mouth.
* more severe illnesses, such as pneumonia, acute heart failure or pulmonary embolism (a clot in the blood vessels of the lung).
* smoking, which often causes chronic cough (smoker's lung).
* asthma - particularly in children who may only cough and show no wheezing.
* stomach acid coming back up the gullet and spilling over into the windpipe (gastro-oesophageal reflux).
* medicines used in heart disease called angiotensin converting enzyme (ACE) inhibitors.
* bacterial or viral infections in the lungs, eg acute bronchitis, pneumonia, whooping cough, croup in children
* rarely coughing can be provoked by psychological illness
* damage to the nerves that supply the vocal chords (known as vocal chordpalsy) and chronic cough can occur.
Coughing is more efficient when preceded by a full intake of air.
For this reason, patients with weak muscles, poor coordination of airway closure and re-opening, or who have airflow obstruction (as in COPD) will have a poor cough and be susceptible to complications including infection in the lower respiratory tract and pneumonia.
How can coughing be treated?
Coughing is a symptom, not a disease. It is the underlying cause of the cough that needs to be treated.
You should consult your doctor if any of the following symptoms accompany a cough, so that possible underlying causes can be investigated and treated where necessary:
* coughing up phlegm that is green, rusty brown, yellow, blood-stained or foul smelling.
* chest pain.
* shortness of breath or wheezing.
* pain and swelling in the calf.
* recurrent night-time cough.
* whooping cough or croup.
* worsening smoker’s cough.
* sudden weight loss.
* fever and sweating.
* hoarseness of the voice with a chronic cough that doesn’t clear up spontaneously.
If you can't cough but need to, problems soon arise. Equally, when coughing is painful (for example, because of a broken rib), patients try not to cough and this can be dangerous.
Ineffective clearance of the airway can lead to a chest infection and possible pneumonia. In these circumstances, pain-relieving medicine can be useful to permit an efficient cough.
Airways infection
Infections in the breathing tubes can be caused by both bacteria and viruses, although the most common cause in children is a virus. Bacterial infections can be treated with antibiotics, but viral infections cannot.
Vaccination has greatly diminished the incidence of whooping cough (pertussis), but if this is the diagnosis, antibiotic treatment with a macrolide antibiotic such as erythromycin decreases the severity of this illness within the first week of treatment.
Asthma
Asthma may cause coughing without wheeziness. This tends to be worst through the night, disturbing sleep. It may be the first sign of asthma in children, or a warning sign that asthma is worsening or not controlled properly. Conventional asthma treatment with inhaled anti-inflammatory preventative medicines and relievers will usually relieve a cough that is due to asthma.
However, a metered-dose inhaler may itself induce cough, and you may need to use a large volume spacer device or a dry powder inhaler instead.
Gastro-oesophageal reflux
Gastro-oesophageal reflux requires treatment with antacids to neutralise the stomach acid, or H2 antagonists or proton-pump inhibitors to reduce the production of stomach acid.
Smoking
Giving up cigarettes will lessen or abolish smokers' cough in 94 per cent of people within four weeks.
ACE inhibitors
If an ACE inhibitor is the cause of coughing, switching to alternate treatment such as an angiotensin II receptor antagonist will help.
How effective are cough medicines?
In cases where a cough is particularly annoying, but not life-threatening, a simple cough mixture may be useful. There are a range of over-the-counter medicines that can be helpful in such circumstances.
Taking these can be justified when there is no special reason to suspect any serious underlying disease, such as the symptoms listed above. You should ask your pharmacist for advice on which of the many available over-the-counter cough remedies are suitable for you.
A productive, chesty cough, in which phlegm is coughed up, should be treated with an expectorant cough mixture to help loosen the phlegm and make it easier to cough up from the airways. Expectorants contain ingredients such as guaifenesin, ipecachuana or ammonium citrate.
A non-productive, dry, tickly or irritating cough, in which no phlegm is coughed up can, be treated with a cough suppressant to reduce the cough reflex. Cough suppressants include pholcodine, dextromethorphan and codeine. Other cough suppressants include simple linctus, glycerin and lemon and honey, which coat and soothe the back of the throat.
Antihistamines such as diphenhydramine and promethazine reduce the cough reflex and also dry up nasal secretions, which can be useful for coughs that are caused by a postnasal drip (mucus running down the back of the throat), or are associated with a cold.
Ipratropium bromide nasal spray also reduces watery nasal secretions that can cause postnasal drip and contribute to a cough.
Some cough remedies also contain sympathomimetics such as ephedrine, for their airway relaxing and decongestant effects, and can be useful if you have a blocked nose as well as a cough.
Patients should not treat themselves with cough mixture for any longer than two weeks. If the cough persists, a visit to the doctor is definitely required - informed medical assessment will help identify the underlying cause and allow treatment.
What if a young child has a cough?
Older children and adults usually have some idea whether their cough is caused by a foreign body, dust or smoke particles, or an infection in the breathing tubes. Clinical inspection will reveal features that may suggest a specific cause.
If a young child coughs, parents need to be able to tell whether the cough is a sign of disease or whether their child has a foreign body in their respiratory passages.
* If your child also has a fever or a cold, the cough is a sign of an infection. If nothing else seems to be wrong, wait for the cough to go away. If the coughing goes on for more than a couple of days, consult a doctor.
* If the coughing comes on suddenly, and is very forceful, it's likely your child has swallowed something that's causing the cough. This could be life-threatening for your child, who could choke. Lift your child by the legs so their head points downwards, then slap their back with a cupped hand. If this doesn't help, call an ambulance immediately.
* If at any point your child seems very ill, you should consult an emergency doctor immediately.
Diagnostic testing for chronic cough
If you suffer from a chronic cough, tests will need to be carried out to determine the cause.
* After initial assessment, a chest X-ray is taken to ensure that serious diseases such as lung cancer or tuberculosis (TB) are unlikely.
* Blood and skin tests are of little help, although they may reveal an allergic tendency.
* Sputum (phlegm) examination for bacteria, TB and cancer cells can be ordered, together with non-invasive heart tests such as an ECG or even echocardiography.
* In difficult cases, further tests can be considered, including fibre optic bronchoscopy, CT examination of the chest and sinuses and even methacholine inhalation challenge or oesophageal pH monitoring. These are only available in special centres.
Whether a particular factor is responsible for chronic coughing can be determined when treatment for a specific cause achieves some benefit for the patient.
But often there is more than one cause for the cough, in which case treating only one factor will not succeed in completely relieving the symptoms. This is frustrating for both you and your medical adviser.
In such a case, a progressive and incremental approach is appropriate. Treatment directed at a specific cause is started and the result assessed.
If there is a partial but incomplete response, other treatments are then tried in turn. Eventually, the vast majority of coughing can be successfully managed in this manner.
If treatment is fruitless with no realistic chance of working - for example in the case of advanced lung cancer, the use of powerful cough suppressants may be justified.
Based on a text by Dr Ole Davidsen, specialist
source : NetDoctor
Cold (common cold) :::
What is a cold?
A cold is a contagious viral disease which infects the soft lining (mucous membrane) of the nose. There are more than 100 different viruses which can result in a cold. The characteristic symptom is a runny nose.
Usually, it is a mild condition, recovery taking place within about a week. However, sometimes the same symptoms occur with other illnesses like influenza.
It is most common during the cold winter months and affects children and adults of all ages. Most people will catch a cold two to four times a year.
How do we catch a cold?
A person is contagious from the day before the illness breaks out until one to three days after they feel better. The infection is spread by airborne droplets when the sufferer coughs or sneezes.
It can also be spread by hand if someone has the virus on their hands and then puts them close to their eyes or nose. This is possibly the most common way of catching a cold.
What are the symptoms of a cold?
* A sore throat.
* There may be pain on swallowing.
* Sneezing.
* The nose begins to run with a water-like secretion which gradually becomes thicker and more yellow.
* As the mucous membrane of the nose swells it may be hard to breathe through the nose.
* An oppressive feeling in the ears.
* Headache.
* Coughing.
* A feeling of being unwell.
* A high temperature. Children are more likely to run a temperature than adults.
What can you do to avoid catching a cold?
* If possible, stay away from people with colds.
* Avoid crowded places where the risk of infection is greater.
* Do not touch your nose or eyes after being in physical contact with somebody that has a cold.
* Wash your hands thoroughly, especially after blowing your nose.
* Keep rooms well aired.
How does the doctor make a diagnosis?
Consultations with a doctor are unnecessary, unless the cold causes other infections.
Outlook
Usually a common cold causes no serious trouble and symptoms will clear up in one to two weeks. Possible complications include inflammation of the eyes, sinusitis, inflammation of the middle ear, tonsillitis, and pneumonia. The reason for these complications may be that a germ infects the irritated mucous membrane.
How do you treat a cold ?
* There is no effective way of treating an ordinary cold. If the sufferer has no other diseases than the common cold, and it goes away in one to two weeks, there is no reason to see a doctor. Since a cold is caused by a virus, antibiotics are not appropriate.
* Symptoms such as cough, sore throat, nasal congestion and headache can be relieved by a variety of over-the-counter medicines. You can get advice from a pharmacist about which are most suitable for you and your symptoms.
* There is no need to reduce daily activities but you should expect to become tired more easily.
* The symptoms can be relieved by warm drinks.
* Nasal decongestants may ease breathing.
* Sleep with the head on a high pillow.
* Avoid smoking; it irritates the mucous membrane of the nose further.
* Throw away paper tissues after use to prevent the spread of infection.
Based on a text by Dr Hanne Korsholm, GP
Source : NetDoctor
A cold is a contagious viral disease which infects the soft lining (mucous membrane) of the nose. There are more than 100 different viruses which can result in a cold. The characteristic symptom is a runny nose.
Usually, it is a mild condition, recovery taking place within about a week. However, sometimes the same symptoms occur with other illnesses like influenza.
It is most common during the cold winter months and affects children and adults of all ages. Most people will catch a cold two to four times a year.
How do we catch a cold?
A person is contagious from the day before the illness breaks out until one to three days after they feel better. The infection is spread by airborne droplets when the sufferer coughs or sneezes.
It can also be spread by hand if someone has the virus on their hands and then puts them close to their eyes or nose. This is possibly the most common way of catching a cold.
What are the symptoms of a cold?
* A sore throat.
* There may be pain on swallowing.
* Sneezing.
* The nose begins to run with a water-like secretion which gradually becomes thicker and more yellow.
* As the mucous membrane of the nose swells it may be hard to breathe through the nose.
* An oppressive feeling in the ears.
* Headache.
* Coughing.
* A feeling of being unwell.
* A high temperature. Children are more likely to run a temperature than adults.
What can you do to avoid catching a cold?
* If possible, stay away from people with colds.
* Avoid crowded places where the risk of infection is greater.
* Do not touch your nose or eyes after being in physical contact with somebody that has a cold.
* Wash your hands thoroughly, especially after blowing your nose.
* Keep rooms well aired.
How does the doctor make a diagnosis?
Consultations with a doctor are unnecessary, unless the cold causes other infections.
Outlook
Usually a common cold causes no serious trouble and symptoms will clear up in one to two weeks. Possible complications include inflammation of the eyes, sinusitis, inflammation of the middle ear, tonsillitis, and pneumonia. The reason for these complications may be that a germ infects the irritated mucous membrane.
How do you treat a cold ?
* There is no effective way of treating an ordinary cold. If the sufferer has no other diseases than the common cold, and it goes away in one to two weeks, there is no reason to see a doctor. Since a cold is caused by a virus, antibiotics are not appropriate.
* Symptoms such as cough, sore throat, nasal congestion and headache can be relieved by a variety of over-the-counter medicines. You can get advice from a pharmacist about which are most suitable for you and your symptoms.
* There is no need to reduce daily activities but you should expect to become tired more easily.
* The symptoms can be relieved by warm drinks.
* Nasal decongestants may ease breathing.
* Sleep with the head on a high pillow.
* Avoid smoking; it irritates the mucous membrane of the nose further.
* Throw away paper tissues after use to prevent the spread of infection.
Based on a text by Dr Hanne Korsholm, GP
Source : NetDoctor
Burns :::
What are burns?
Burns are skin damage caused by contact with fire, heat, electricity, radiation, or caustic chemicals.
Burns are classified according to the depth and extent of the skin damage, in the following way.
The first thing to do is to limit the extent of the damage, and prevent the burn from becoming worse.
The kitchen is the most dangerous room in the house, and the most likely place for burns and scalds to occur.
When cooking, keep small children away from hot drinks, pans and kettles, barbecues and other open flames. Remember that barbecues can suddenly 'spit' flames when inflammable liquids are poured over them. Barbecues are a major cause of serious burns.
When there are small children in the house, fill baths by running the cold tap first.
Never throw water over oil fires, such as in a chip pan, because this will cause a fire explosion that can have severe consequences. Instead the fire should be smothered by covering the pan with a damp cloth.
Buy a proper fire-smothering blanket and keep it somewhere in the kitchen where it is easily accessible.
Based on a text by Eric Olesen, plastic surgeon
Burns are skin damage caused by contact with fire, heat, electricity, radiation, or caustic chemicals.
Burns are classified according to the depth and extent of the skin damage, in the following way.
- First-degree burns: the skin is red, painful and very sensitive to touch. The damaged skin may be slightly moist from leakage of the fluid in the deeper layers of the skin.
- Second-degree burns: the damage is deeper and blisters usually appear on the skin. The skin is still painful and sensitive.
- Third-degree burns: the tissues in all layers of the skin are dead. Usually there are no blisters. The burned surface can appear normal, white, black (charred), or bright red from blood in the bottom of the wound. Damage to skin nerves can mean it is quite painless. The burned skin lacks sensation to touch. A skin graft is usually necessary for significant areas.
The first thing to do is to limit the extent of the damage, and prevent the burn from becoming worse.
- The burnt area must be cooled by being placed under cold running water. The water must not be unpleasantly cold.
- The damaged area must stay under running water for at least one hour, or longer if the pain has not stopped. Up to four hours of this treatment can be beneficial.
- First-degree burns, eg mild sunburn, do not require this treatment.
- Burns that are bigger than the palm of the hand.
- Burns on the face, neck, hands, and in the groin.
- All third-degree burns.
- Most second-degree burns.
- If possible, keep pouring water over the burn on the way to the doctor, or use clean, soaking wet towels.
- Do not lance the blisters yourself.
- Never apply an ointment to burns or try other folk remedies - water is the only thing that should be used. Do not use butter or lard on burns!
- Do not forget to have a tetanus injection if you have not had a booster within the last 10 years.
- When skin is burned, it loses its ability to protect, which increases the risk of infection. So it is important that the damaged area be thoroughly cleansed within the first six hours, and that the area is kept clean while it is healing.
- Severe burns can cause scarring.
- In cases of extensive severe burns, the body may lose large quantities of fluid. This can disturb the blood circulation and cause problems with the body's salt balance. Such injuries should be assessed at your local Accident and Emergency department.
The kitchen is the most dangerous room in the house, and the most likely place for burns and scalds to occur.
When cooking, keep small children away from hot drinks, pans and kettles, barbecues and other open flames. Remember that barbecues can suddenly 'spit' flames when inflammable liquids are poured over them. Barbecues are a major cause of serious burns.
When there are small children in the house, fill baths by running the cold tap first.
Never throw water over oil fires, such as in a chip pan, because this will cause a fire explosion that can have severe consequences. Instead the fire should be smothered by covering the pan with a damp cloth.
Buy a proper fire-smothering blanket and keep it somewhere in the kitchen where it is easily accessible.
Based on a text by Eric Olesen, plastic surgeon
Bedwetting (enuresis) :::
What is Bedwetting ( sleepwetting ) ?
Is bedwetting common?
Enuresis - the medical name for bedwetting - is the involuntary passing of urine and the most common form of bedwetting among children is nocturnal enuresis, ie that which occurs at night.
Frequent bedwetting is common in children up to the age of six. The child should not be put under pressure if younger than six - children do not wet the bed on purpose.
Approximately 15 to 20 per cent of all five- and six-year-olds wet the bed and most of them are boys. With teenagers, the figure is 2 to 3 per cent up to 14 and 1 per cent at 15 or over.
Why do children wet the bed?
Most children who wet the bed have done it all their life and in many cases no reason can be found.
Often it is passed on through the family. Bedwetting also happens, or has happened, to a close relative in up to 85 per cent of cases. About 57 per cent of children who wet their beds either have a brother, sister or a parent who has experienced the same problem.
It may have a medical or psychological cause such as cystitis, diabetes, problems at school, at home, or the divorce of parents.
One explanation could be that these children are heavy sleepers who do not wake up when their bladder is full. Also, some children develop bladder control later than others.
At night, some children produce too little of the antidiuretic hormone (ADH), which controls the production of urine. Tablets containing desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.
What can I do to help the child?
Try using a bedwetting alarm which makes a ringing or buzzing sound or vibrates if the child wets the bed. These are successful in curing the condition in 70 per cent of cases.
The alarm is very effective because it makes your child wake up as soon as the first drop of urine hits the underwear or the sheet. Your child is thus made aware that they are urinating and what it feels like when their bladder is full.
There are different kinds of alarms. Some have a copper net which is placed under the sheet. The net is connected to a bell, which will go off as soon as the first drop of urine hits the sheet. Others have a small sensor, which is placed in the pants, and is also connected to a bell.
Do not make the bedwetting a big issue in the family. Most children are embarrassed about wetting the bed, so it will help if the family support the child and show a positive attitude. Don't get angry with the child or punish them if they wet their bed. This could only make matters worse.
Let the child know that many other children do it too. If someone in the family has had the same problem, tell the child about it. Knowing that others have been affected in the same way will help a child deal with the problem.
Make sure the child doesn't drink very much during the two hours prior to bedtime. There is still no guarantee that the child will not wet the bed, but it may help.
Ensure the child goes to the toilet before getting into bed. Protect the bed by using a waterproof mattress, or a fitted waterproof mattress cover under the bottom sheet. This must be fastened securely to prevent any danger of suffocation. Place clean nightclothes and sheets next to the bed so the child can change if they wake up.
Let the child change the sheets; not as a punishment, but in order to learn to deal with the problem. It will also make the child more aware of the situation. If the child is in agreement, keep a calendar or diary and mark dry nights with a star. Praise the child when he or she wakes up in the morning without having wet the bed. Encouragement is often the most helpful way of dealing with the problem.
Some children take longer than others to achieve night-time dryness - initially having maybe one or two dry nights a week and gradually building up the number of dry nights over the following months.
However, if your child is persistently wet every night for a week or two he or she may not be ready to become dry. In this case, as a temporary measure, you may wish to use absorbent night-time pants rather than going back to using nappies. You could then try again in about three to four months.
Many parents have been told to wake the child in the middle of the night and make them go to the bathroom. Studies show that the positive effect of this is almost non-existent, since the child does not wake up by him or herself because of the need to urinate.
It may take weeks or months before there is any change. Training a child will take time, so patience is required from all involved. Most children naturally stop wetting the bed eventually. Do not be embarrassed to discuss further options with your doctor or health visitor if none of the above suggestions appear to be effective.
When should a child be taken to the doctor?
* If the child still wets the bed after the age of six.
* If the child suddenly starts wetting the bed without having done so earlier.
* If the child's urine has a strong smell, or if the child says that it hurts during or after urination.
* If the child starts to wet themself during the day.
* If the child urinates more than usual, day or night.
* If the child has constipation or defecates in their pants.
What will the doctor do?
The doctor will start by asking questions about the child, such as when they learnt to go to the toilet in the daytime. They will probably also ask if someone else in the family has had the same problem. After this, the doctor will examine the child, feeling their stomach and abdomen. Often, the doctor will ask for a urine sample in order to rule out a bacterial infection or cystitis. The doctor may also take a blood sample.
What kinds of medical treatment are available?
If bedwetting is caused by too little of the antidiuretic hormone (ADH), which controls the production of urine, tablets containing Desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.
Imipramine, a tricyclic antidepressant medicine, has been found to be useful in some cases for reasons which are not fully understood.
Based on a text by Dr Bettina Norby
Bedwetting (or sleepwetting) is involuntary urination while asleep after the age at which bladder control would normally be anticipated.
Most children (85-90%) will consistently stay dry by age 6. By age 10, 95% of children are dry at night. Studies place adult bedwetting rates at between 0.5% to 2.3%.
A small percentage (5 to 10%) of bedwetting cases are caused by specific medical situations. Most cases, however, do not have a specific identifiable cause. ( source : wikpedia )
Is bedwetting common?
Enuresis - the medical name for bedwetting - is the involuntary passing of urine and the most common form of bedwetting among children is nocturnal enuresis, ie that which occurs at night.
Frequent bedwetting is common in children up to the age of six. The child should not be put under pressure if younger than six - children do not wet the bed on purpose.
Approximately 15 to 20 per cent of all five- and six-year-olds wet the bed and most of them are boys. With teenagers, the figure is 2 to 3 per cent up to 14 and 1 per cent at 15 or over.
Why do children wet the bed?
Most children who wet the bed have done it all their life and in many cases no reason can be found.
Often it is passed on through the family. Bedwetting also happens, or has happened, to a close relative in up to 85 per cent of cases. About 57 per cent of children who wet their beds either have a brother, sister or a parent who has experienced the same problem.
It may have a medical or psychological cause such as cystitis, diabetes, problems at school, at home, or the divorce of parents.
One explanation could be that these children are heavy sleepers who do not wake up when their bladder is full. Also, some children develop bladder control later than others.
At night, some children produce too little of the antidiuretic hormone (ADH), which controls the production of urine. Tablets containing desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.
What can I do to help the child?
Try using a bedwetting alarm which makes a ringing or buzzing sound or vibrates if the child wets the bed. These are successful in curing the condition in 70 per cent of cases.
The alarm is very effective because it makes your child wake up as soon as the first drop of urine hits the underwear or the sheet. Your child is thus made aware that they are urinating and what it feels like when their bladder is full.
There are different kinds of alarms. Some have a copper net which is placed under the sheet. The net is connected to a bell, which will go off as soon as the first drop of urine hits the sheet. Others have a small sensor, which is placed in the pants, and is also connected to a bell.
Do not make the bedwetting a big issue in the family. Most children are embarrassed about wetting the bed, so it will help if the family support the child and show a positive attitude. Don't get angry with the child or punish them if they wet their bed. This could only make matters worse.
Let the child know that many other children do it too. If someone in the family has had the same problem, tell the child about it. Knowing that others have been affected in the same way will help a child deal with the problem.
Make sure the child doesn't drink very much during the two hours prior to bedtime. There is still no guarantee that the child will not wet the bed, but it may help.
Ensure the child goes to the toilet before getting into bed. Protect the bed by using a waterproof mattress, or a fitted waterproof mattress cover under the bottom sheet. This must be fastened securely to prevent any danger of suffocation. Place clean nightclothes and sheets next to the bed so the child can change if they wake up.
Let the child change the sheets; not as a punishment, but in order to learn to deal with the problem. It will also make the child more aware of the situation. If the child is in agreement, keep a calendar or diary and mark dry nights with a star. Praise the child when he or she wakes up in the morning without having wet the bed. Encouragement is often the most helpful way of dealing with the problem.
Some children take longer than others to achieve night-time dryness - initially having maybe one or two dry nights a week and gradually building up the number of dry nights over the following months.
However, if your child is persistently wet every night for a week or two he or she may not be ready to become dry. In this case, as a temporary measure, you may wish to use absorbent night-time pants rather than going back to using nappies. You could then try again in about three to four months.
Many parents have been told to wake the child in the middle of the night and make them go to the bathroom. Studies show that the positive effect of this is almost non-existent, since the child does not wake up by him or herself because of the need to urinate.
It may take weeks or months before there is any change. Training a child will take time, so patience is required from all involved. Most children naturally stop wetting the bed eventually. Do not be embarrassed to discuss further options with your doctor or health visitor if none of the above suggestions appear to be effective.
When should a child be taken to the doctor?
* If the child still wets the bed after the age of six.
* If the child suddenly starts wetting the bed without having done so earlier.
* If the child's urine has a strong smell, or if the child says that it hurts during or after urination.
* If the child starts to wet themself during the day.
* If the child urinates more than usual, day or night.
* If the child has constipation or defecates in their pants.
What will the doctor do?
The doctor will start by asking questions about the child, such as when they learnt to go to the toilet in the daytime. They will probably also ask if someone else in the family has had the same problem. After this, the doctor will examine the child, feeling their stomach and abdomen. Often, the doctor will ask for a urine sample in order to rule out a bacterial infection or cystitis. The doctor may also take a blood sample.
What kinds of medical treatment are available?
If bedwetting is caused by too little of the antidiuretic hormone (ADH), which controls the production of urine, tablets containing Desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.
Imipramine, a tricyclic antidepressant medicine, has been found to be useful in some cases for reasons which are not fully understood.
Based on a text by Dr Bettina Norby
Earache :::
What is Earache/Otalgia ?
Otalgia is ear pain or an earache. Primary otalgia is from pain that originates inside the ear. Referred otalgia is from pain that originates from outside the ear. ( source : wikipedia )
Earache is mainly due to problems in either the outer ear (from the earlobe to the eardrum) or the middle ear (behind the eardrum). In some cases, problems in the throat or the mouth, such as tonsillitis, can also cause earache.
Listed below are some common reasons for earache.
Ear wax
Ear wax can gather in the ear canal (auditory canal). Eventually it can form an ear plug, which impairs hearing and may cause pain.
Using a cotton bud doesn't help because this usually only pushes the wax further inside the ear, doing more harm than good. It also carries the risk of perforating the eardrum.
A plug can be softened with a little olive or vegetable oil. Drops can also be bought at the chemists that are designed for this purpose.
The practice nurse at your doctor's surgery may syringe the ears by flushing out the ear wax with water.
Inflammation of the middle ear
Usually earache starts further inside the ear. Inflammation of the middle ear is the most frequent cause and is often (although not always) due to an infection.
Because of increased pressure in the middle ear, the eardrum is stretched and swollen. This impairs hearing and is painful.
Mild painkillers such as paracetamol can be used if the pain is severe.
Antibiotics may also be prescribed. However, the role of antibiotics is still uncertain. They probably do not offer any benefit in the majority of people with inflammation of the middle ear, and often are associated with side effects.
Eczema
Eczema can occur in the auditory canal, causing dry, red, scaly and itchy skin. This can also become infected and painful.
Eczema sufferers should be careful about putting cotton buds into their ear because it usually only makes matters worse. Ear drops containing corticosteroids may relieve and heal the irritated auditory canal. Antibacterials or antifungals may be required if there is infection.
Otalgia is ear pain or an earache. Primary otalgia is from pain that originates inside the ear. Referred otalgia is from pain that originates from outside the ear. ( source : wikipedia )
Earache is mainly due to problems in either the outer ear (from the earlobe to the eardrum) or the middle ear (behind the eardrum). In some cases, problems in the throat or the mouth, such as tonsillitis, can also cause earache.
Listed below are some common reasons for earache.
Ear wax
Ear wax can gather in the ear canal (auditory canal). Eventually it can form an ear plug, which impairs hearing and may cause pain.
Using a cotton bud doesn't help because this usually only pushes the wax further inside the ear, doing more harm than good. It also carries the risk of perforating the eardrum.
A plug can be softened with a little olive or vegetable oil. Drops can also be bought at the chemists that are designed for this purpose.
The practice nurse at your doctor's surgery may syringe the ears by flushing out the ear wax with water.
Inflammation of the middle ear
Usually earache starts further inside the ear. Inflammation of the middle ear is the most frequent cause and is often (although not always) due to an infection.
Because of increased pressure in the middle ear, the eardrum is stretched and swollen. This impairs hearing and is painful.
Mild painkillers such as paracetamol can be used if the pain is severe.
Antibiotics may also be prescribed. However, the role of antibiotics is still uncertain. They probably do not offer any benefit in the majority of people with inflammation of the middle ear, and often are associated with side effects.
Eczema
Eczema can occur in the auditory canal, causing dry, red, scaly and itchy skin. This can also become infected and painful.
Eczema sufferers should be careful about putting cotton buds into their ear because it usually only makes matters worse. Ear drops containing corticosteroids may relieve and heal the irritated auditory canal. Antibacterials or antifungals may be required if there is infection.
Fever in children :::
What is Fever ?
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). The temperature is measured with a thermometer.
Source : Dictionary of Medicine (Shahram)
Temperature control in the body
The 'core temperature' means the temperature of the deep tissues of the body and in normal circumstances this is kept at a very even level by a range of automatic adjustments.
When we are too hot we increase the amount of blood flowing through the skin by opening up the tiny capillary blood vessels. This radiates away excess heat and sweating can further enhance this.
When we are too cold we shut down skin blood vessels and conserve heat within the internal organs. If necessary we can generate more heat by shivering.
Fever is part of the body's defence mechanism against viruses or bacteria. The body tries to create extra heat so that the foreign organism cannot survive. Having a temperature helps you fight illness.
Actions to reduce a fever can help make someone feel more comfortable but it is not possible, or desirable, to aim to normalise the temperature while someone is fighting off an infection.
The part of the human brain that controls body temperature is not fully developed in children. This means that a child’s temperature may rise and fall very quickly and the child is sensitive to the temperature of his or her surroundings.
One of the simplest and most effective ways to help a child with a fever feel more comfortable is to take off some of the child's clothes so heat can escape from their body more easily.
What is the normal temperature for a child?
If you take the temperature in your child's mouth or from the ear, the normal temperature is 36-36.8ºC (97.7-99.1ºF).
Thermometers
Traditional mercury thermometers are being phased out although many are still around. Mercury is a highly toxic substance if taken into the body, which can be done through skin contact, breathing in the vapour or swallowing it.
All these risks can apply to the fragile glass thermometer if it is broken, for example by a child biting it.
If you have a mercury thermometer, check with your local council how to dispose of it safely.
Modern probe-type digital thermometers are quicker to use, more reliable and are much safer if bitten.
Taking a child's temperature
A body temperature reading can be taken from the mouth, armpit, ear, skin surface or the rectum.
Although a rectal temperature reading is the most accurate and is quite often used in hospital it is not necessary to be so precise when taking temperature readings at home. Rectal temperature reading is therefore not recommended for home use.
Rectal temperatures are the closest to 'core' temperature and are about 0.5ºC (2ºF) higher than readings taken from the mouth or ear.
Temperature readings from the armpit are not very reliable and are about 0.5ºC lower than mouth temperature.
Thermometer strips that are placed on the child's forehead are popular and give a rough guide.
Most of the time the exact level of a child’s temperature is not particularly important, unless it is very high (39ºC or over).
In practical terms the temperature reading will be enough to give an indication of whether a fever is present.
Liquids
A child with a high temperature needs more liquid than usual, because the fever will make them sweat a lot.
Make sure your child drinks plenty of liquids - a teaspoonful every few minutes, if necessary. Provided they drink plenty of liquids, it won't matter too much if they eat very little for a couple of days.
Look at your child and use common sense. Do they look exhausted or ill? Are they behaving differently? If the answer is yes, call the doctor. You should also call your doctor if:
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). The temperature is measured with a thermometer.
Source : Dictionary of Medicine (Shahram)
Temperature control in the body
The 'core temperature' means the temperature of the deep tissues of the body and in normal circumstances this is kept at a very even level by a range of automatic adjustments.
When we are too hot we increase the amount of blood flowing through the skin by opening up the tiny capillary blood vessels. This radiates away excess heat and sweating can further enhance this.
When we are too cold we shut down skin blood vessels and conserve heat within the internal organs. If necessary we can generate more heat by shivering.
Fever is part of the body's defence mechanism against viruses or bacteria. The body tries to create extra heat so that the foreign organism cannot survive. Having a temperature helps you fight illness.
Actions to reduce a fever can help make someone feel more comfortable but it is not possible, or desirable, to aim to normalise the temperature while someone is fighting off an infection.
The part of the human brain that controls body temperature is not fully developed in children. This means that a child’s temperature may rise and fall very quickly and the child is sensitive to the temperature of his or her surroundings.
One of the simplest and most effective ways to help a child with a fever feel more comfortable is to take off some of the child's clothes so heat can escape from their body more easily.
What is the normal temperature for a child?
If you take the temperature in your child's mouth or from the ear, the normal temperature is 36-36.8ºC (97.7-99.1ºF).
Thermometers
Traditional mercury thermometers are being phased out although many are still around. Mercury is a highly toxic substance if taken into the body, which can be done through skin contact, breathing in the vapour or swallowing it.
All these risks can apply to the fragile glass thermometer if it is broken, for example by a child biting it.
If you have a mercury thermometer, check with your local council how to dispose of it safely.
Modern probe-type digital thermometers are quicker to use, more reliable and are much safer if bitten.
Taking a child's temperature
A body temperature reading can be taken from the mouth, armpit, ear, skin surface or the rectum.
Although a rectal temperature reading is the most accurate and is quite often used in hospital it is not necessary to be so precise when taking temperature readings at home. Rectal temperature reading is therefore not recommended for home use.
Rectal temperatures are the closest to 'core' temperature and are about 0.5ºC (2ºF) higher than readings taken from the mouth or ear.
Temperature readings from the armpit are not very reliable and are about 0.5ºC lower than mouth temperature.
Thermometer strips that are placed on the child's forehead are popular and give a rough guide.
Most of the time the exact level of a child’s temperature is not particularly important, unless it is very high (39ºC or over).
In practical terms the temperature reading will be enough to give an indication of whether a fever is present.
- Ear temperature
- To get a reliable temperature measurement, the thermometer must be used exactly as directed.
- When you buy the thermometer, ask the salesperson how to use it, and read the instructions carefully before you start.
- Especially with small children, ear thermometers require a steady hand to find the right spot.
- The ear canal has a natural curve, so to ensure that the thermometer is pointing towards the eardrum it may be necessary to pull the top part of your child's ear gently upwards during the reading.
- If your child has been lying with their head on a warm pillow, or has just come inside out of the cold, you will need to wait 10 to 15 minutes before the ear can provide an accurate measurement of body temperature.
If you are willing to pay for an ear thermometer, this is a very quick method and will give a read-out in seconds. Ear thermometers rely on measuring infrared (heat) radiation from the eardrum.
Other types of thermometer (such as the probe type) are not suitable for taking ear readings and must never be placed within the ear canal.
Some ear thermometers are adjustable so they can be made suitable for adults or children.
- Under the armpit
- With children old enough to co-operate and keep still you need to keep the thermometer under their armpit for at least 5 minutes.
This method is not good for small children, since they will not stay still for long enough.
- From the mouth
- The thermometer is placed in the mouth, under the tongue.
- It will take two to three minutes to measure the temperature accurately.
- If your child has just eaten anything hot or cold, you will need to wait 10 minutes before an accurate temperature can be taken.
This method is not suitable for a young child, because they may bite the thermometer and break it.
Liquids
A child with a high temperature needs more liquid than usual, because the fever will make them sweat a lot.
Make sure your child drinks plenty of liquids - a teaspoonful every few minutes, if necessary. Provided they drink plenty of liquids, it won't matter too much if they eat very little for a couple of days.
- Rest
A child with a high temperature also needs rest and sleep. They do not have to be in bed all day if they feel like playing, but they must have the opportunity to lie down.
- Body temperature
You do not sweat out a fever. If your child shivers while their temperature is rising, it's okay to cover them with a duvet or a blanket. But as soon as your child's temperature has stabilised and he or she starts sweating, they need to cool down.
Your child only needs to wear underwear or a nappy, which will help the heat escape from the body. Make sure their room is ventilated and cool, but not draughty.
- Medicines
If you want to use medication to get the temperature down, ask your doctor or pharmacist. They will be able to tell you what to use and how much. The dosage will depend on both the age and weight of your child.
Paracetamol suspension (eg Calpol) is the usual choice and ibuprofen (eg Nurofen for children) is an alternative. Aspirin should not be given to children under 16 years of age.
- Attention
Sick children are often tired and bad-tempered. They sleep a lot and when they are awake; they want their parents around all the time. They might whine and act younger than their age.
It is okay to give in and spoil a child a little when they are sick. Read to them, play with them and spend time with them. This is not the time to teach a child good manners.
A child usually recovers quickly and will go back to their old self again.
Look at your child and use common sense. Do they look exhausted or ill? Are they behaving differently? If the answer is yes, call the doctor. You should also call your doctor if:
- you have a young child, less than three months old, who runs a high fever.
- your child cries and cries, without you being able to comfort them, and doesn't wake up easily.
- your child has a temperature over 38ºC (101.3ºF) for more than three days.
- your child has just had an operation.
- your child doesn't seem to be getting better.
- Stiff neck.
- Affected by bright light.
- Hallucinations.
- Red rash or blue/purple dots or patches.
- Trouble breathing.
- Cramps.
- Continued vomiting or diarrhoea.
- Continued tonsillitis.
- Pain when urinating, or urinating more than usual.
- Other illnesses.
Written by Dr Stuart Crisp, paediatric specialist registrar and Dr Per Grinsted, specialist
Source : NetDoctor
Source : NetDoctor
Wasp stings / insect bites ::
Insect bites often cause one or more red bumps that are usually itchy and sometimes painful. Often there is a small hole in the middle of the bite, perhaps with the end of the sting sticking out. Apart from this local irritation, the bite is not usually dangerous provided the victim is not allergic to insect bites.
Bee and wasp stings are more likely to cause allergic reactions than other kinds of insect bites.
What are the sources of insect bites?
The sources of insect bites are recognised to be wide and varied.
Insects, such as fleas can be found on domestic pets, eg dogs and cats; and also on birds.
Bedding and other soft furnishings around the house can also harbour bed bugs and fleas.
About 95 per cent of the fleas on a pet will be in the form of eggs, larvae and pupae (ie in the household) rather than on the animal.
Simply working in your garden can expose you to fleas and other insects.
Travelling can also put you at risk. Depending on your destination – exposure to mosquitoes, ticks and sandflies can occur.
Which insects cause stings or bites?
Stings or bites are caused by midges, horseflies, bees, wasps, ants, some spiders, fleas, lice, etc.
What does a bite look like?
There will be one or more swollen red bumps on the skin. In the middle, you will often see a small hole, which might have the insect's sting sticking out of it.
If you wake up in the middle of the night having noticed a painful or itchy lump, check to see if other parts of the body are affected. If there is only one bump, or four or five of them close together, you have probably been stung or bitten. Fleas often bite four or five times in the same area so you may find a couple of these clusters on your body.
Some children's diseases can also cause bumps and red, swollen skin. If in doubt, consult your doctor.
What are the symptoms of insect bites?
The skin becomes red, swollen, itchy and can be painful. These are the most common symptoms. Sometimes bites cause an allergic reaction. Bites can become infected by scratching. Look out for a rash or swelling that gets worse instead of better. If this happens, see a doctor.
Call your doctor immediately if you notice any of the following symptoms:
* the person has been stung by many insects at the same time
* a rash or swelling that gets worse instead of better
* if the site is red, tender and swollen
* headache
* dizziness
* nausea (feeling sick)
* pains in the chest
* choking or wheezing
* difficulty breathing.
These may be symptoms of allergy and can be life-threatening if the victim goes into shock. See a doctor immediately or dial 999 for an ambulance.
How to treat an insect bite or sting
Remove the sting. Use tweezers to prise it out or scrape it off with your fingernail, or a credit card. Do not attempt to press out the sting, as this will only help the poison spread under the skin.
Wash the bite with soap and water, then cool off the skin with ice cubes or an ice-pack that has been wrapped in a cloth or thin towel. Rest the affected area and elevate it if possible to prevent excessive swelling. Do this immediately after the victim has been stung.
If necessary, use a painkilling cream or gel or an antihistamine to soothe the itch. If you or a member of your family are allergic to insect bites, talk to your doctor or pharmacist before going on holiday. They may tell you to take an antihistamine with you in tablet form; or Adrenaline or as an EpiPen injection. If so, make sure you ask how to use them correctly.
Anyone who gets a rash or an itch requiring medical treatment, or who may simply feel unwell following a bite or sting should not drive, as there is a risk of passing out. If in doubt, consult your doctor.
Insect bites and allergies
People who are allergic to insect bites should carry a card, bracelet or necklace that lets other people know about their allergy. If the doctor has prescribed medication for you to be used in case of an allergic reaction, it is important that both you and your family know exactly how to use it.
How to avoid getting stung
* If surrounded by a swarm of bees or wasps, move out of the way slowly. Do not try to wave the insects away. Violent movements will only excite them and make them more aggressive and likely to attack.
* Insect repellents are effective.
* Never aim a blow at a wasps' or bees' nest or attempt to throw them because the insects will immediately attack.
* Stay away from things that attract insects, such as flowers, trees, bushes and piles of wood.
* Be extra careful if you are eating or drinking (especially sweet things) outside.
* Smells and bright colours attract insects. Avoid scented creams and strong perfumes if you are going to spend time outside.
* Long sleeves, long trousers, socks, shoes and gloves help protect you from stings.
* Close the windows in the house and the car to keep the insects out.
* Look out for insects' nests in your home or garden and have them removed immediately.
* Protective gear such as mesh covers for the face can be very effective against the nuisance of the highland midge in summer for example.
Based on a text by Vibeke Manniche, paediatrician, PhD
Bee and wasp stings are more likely to cause allergic reactions than other kinds of insect bites.
What are the sources of insect bites?
The sources of insect bites are recognised to be wide and varied.
Insects, such as fleas can be found on domestic pets, eg dogs and cats; and also on birds.
Bedding and other soft furnishings around the house can also harbour bed bugs and fleas.
About 95 per cent of the fleas on a pet will be in the form of eggs, larvae and pupae (ie in the household) rather than on the animal.
Simply working in your garden can expose you to fleas and other insects.
Travelling can also put you at risk. Depending on your destination – exposure to mosquitoes, ticks and sandflies can occur.
Which insects cause stings or bites?
Stings or bites are caused by midges, horseflies, bees, wasps, ants, some spiders, fleas, lice, etc.
What does a bite look like?
There will be one or more swollen red bumps on the skin. In the middle, you will often see a small hole, which might have the insect's sting sticking out of it.
If you wake up in the middle of the night having noticed a painful or itchy lump, check to see if other parts of the body are affected. If there is only one bump, or four or five of them close together, you have probably been stung or bitten. Fleas often bite four or five times in the same area so you may find a couple of these clusters on your body.
Some children's diseases can also cause bumps and red, swollen skin. If in doubt, consult your doctor.
What are the symptoms of insect bites?
The skin becomes red, swollen, itchy and can be painful. These are the most common symptoms. Sometimes bites cause an allergic reaction. Bites can become infected by scratching. Look out for a rash or swelling that gets worse instead of better. If this happens, see a doctor.
Call your doctor immediately if you notice any of the following symptoms:
* the person has been stung by many insects at the same time
* a rash or swelling that gets worse instead of better
* if the site is red, tender and swollen
* headache
* dizziness
* nausea (feeling sick)
* pains in the chest
* choking or wheezing
* difficulty breathing.
These may be symptoms of allergy and can be life-threatening if the victim goes into shock. See a doctor immediately or dial 999 for an ambulance.
How to treat an insect bite or sting
Remove the sting. Use tweezers to prise it out or scrape it off with your fingernail, or a credit card. Do not attempt to press out the sting, as this will only help the poison spread under the skin.
Wash the bite with soap and water, then cool off the skin with ice cubes or an ice-pack that has been wrapped in a cloth or thin towel. Rest the affected area and elevate it if possible to prevent excessive swelling. Do this immediately after the victim has been stung.
If necessary, use a painkilling cream or gel or an antihistamine to soothe the itch. If you or a member of your family are allergic to insect bites, talk to your doctor or pharmacist before going on holiday. They may tell you to take an antihistamine with you in tablet form; or Adrenaline or as an EpiPen injection. If so, make sure you ask how to use them correctly.
Anyone who gets a rash or an itch requiring medical treatment, or who may simply feel unwell following a bite or sting should not drive, as there is a risk of passing out. If in doubt, consult your doctor.
Insect bites and allergies
People who are allergic to insect bites should carry a card, bracelet or necklace that lets other people know about their allergy. If the doctor has prescribed medication for you to be used in case of an allergic reaction, it is important that both you and your family know exactly how to use it.
How to avoid getting stung
* If surrounded by a swarm of bees or wasps, move out of the way slowly. Do not try to wave the insects away. Violent movements will only excite them and make them more aggressive and likely to attack.
* Insect repellents are effective.
* Never aim a blow at a wasps' or bees' nest or attempt to throw them because the insects will immediately attack.
* Stay away from things that attract insects, such as flowers, trees, bushes and piles of wood.
* Be extra careful if you are eating or drinking (especially sweet things) outside.
* Smells and bright colours attract insects. Avoid scented creams and strong perfumes if you are going to spend time outside.
* Long sleeves, long trousers, socks, shoes and gloves help protect you from stings.
* Close the windows in the house and the car to keep the insects out.
* Look out for insects' nests in your home or garden and have them removed immediately.
* Protective gear such as mesh covers for the face can be very effective against the nuisance of the highland midge in summer for example.
Based on a text by Vibeke Manniche, paediatrician, PhD
Threadworm (pinworm) :::
What is threadworm?
Threadworm (Enterobius vermicularis) is the most common worm infection. Both children and adults can be infected, although it is mostly found in children.
How does infection spread?
Threadworm is passed from person to person and is usually spread via children.
The female worms lay eggs on a person's skin around the anus. This leads to itching and scratching of the area and then leads to eggs being transferred onto the fingers.
The eggs can then be passed by direct contact, or through sharing toys, pencils and food, etc.
Good hygiene is essential to stop the infection being spread, including washing hands and scrubbing under the nails before eating and after visiting the toilet.
Eggs can survive in dust for two weeks, which may lead to infection by inhaling dust. Children in childcare institutions are easily infected by each other.
Symptoms
Threadworm begins with an itchy feeling around your anus (back passage), usually at night under warm sheets. Without treatment threadworm may give rise to vaginitis (inflammation of the vagina) in girls and women. You can often see threadworms, a 1cm thread-like worm, in your child's stools or their bottom.
Treatment
Infected children or adults should be treated as soon as possible. The rest of the family should also be treated at the same time. Threadworm can be treated with one of two medicines, mebendazole (eg Ovex) or piperazine (eg Pripsen piperazine), both of which can be bought over the counter from pharmacies. Both medicines can be given as a single dose. Your pharmacist can give you appropriate advice.
Children under two years of age will need to be seen by a doctor. One treatment is usually enough.
Children can still go to school or childcare, in spite of having threadworms.
What can be done to control threadworms?
* If you have threadworms, it is important to shower in the morning in order to remove eggs and bacteria from the anal area.
* Wash your hands thoroughly after each visit to the bathroom and before each meal.
* Underwear should be changed daily.
* Bedsheets should be changed frequently, especially 7 to 10 days after the treatment.
* Infected children and adults should keep their nails short.
* Infected children should ideally wear cotton gloves when sleeping.
* Clean your home thoroughly, especially the bedrooms, and remove as much dust as possible.
* Do not eat food in your bedroom.
* If several family members are infected, you should all be treated on the same day.
* Avoid food and drinks containing a lot of sugar, and eat high-fibre food to prevent constipation.
Threadworm (Enterobius vermicularis) is the most common worm infection. Both children and adults can be infected, although it is mostly found in children.
How does infection spread?
Threadworm is passed from person to person and is usually spread via children.
The female worms lay eggs on a person's skin around the anus. This leads to itching and scratching of the area and then leads to eggs being transferred onto the fingers.
The eggs can then be passed by direct contact, or through sharing toys, pencils and food, etc.
Good hygiene is essential to stop the infection being spread, including washing hands and scrubbing under the nails before eating and after visiting the toilet.
Eggs can survive in dust for two weeks, which may lead to infection by inhaling dust. Children in childcare institutions are easily infected by each other.
Symptoms
Threadworm begins with an itchy feeling around your anus (back passage), usually at night under warm sheets. Without treatment threadworm may give rise to vaginitis (inflammation of the vagina) in girls and women. You can often see threadworms, a 1cm thread-like worm, in your child's stools or their bottom.
Treatment
Infected children or adults should be treated as soon as possible. The rest of the family should also be treated at the same time. Threadworm can be treated with one of two medicines, mebendazole (eg Ovex) or piperazine (eg Pripsen piperazine), both of which can be bought over the counter from pharmacies. Both medicines can be given as a single dose. Your pharmacist can give you appropriate advice.
Children under two years of age will need to be seen by a doctor. One treatment is usually enough.
Children can still go to school or childcare, in spite of having threadworms.
What can be done to control threadworms?
* If you have threadworms, it is important to shower in the morning in order to remove eggs and bacteria from the anal area.
* Wash your hands thoroughly after each visit to the bathroom and before each meal.
* Underwear should be changed daily.
* Bedsheets should be changed frequently, especially 7 to 10 days after the treatment.
* Infected children and adults should keep their nails short.
* Infected children should ideally wear cotton gloves when sleeping.
* Clean your home thoroughly, especially the bedrooms, and remove as much dust as possible.
* Do not eat food in your bedroom.
* If several family members are infected, you should all be treated on the same day.
* Avoid food and drinks containing a lot of sugar, and eat high-fibre food to prevent constipation.
Sprains and bruises :::
What are sprains and bruises?
A sprain causes pain, swelling and discolouration (blue colouring). This happens because the small blood vessels and fibres in the flesh burst, causing blood to enter the surrounding tissue. This results in swelling and the blue colouring.
It is the same principle with a bruise: the skin is exposed to such a hard blow that the blood vessels break.
What should I do about a sprain?
If you have a sprain, you will also suffer pain. The injured area must be kept still or the bleeding in the tissue will continue more intensely. The most important treatment for a sprain is: rest, ice, compression, elevation (RICE).
Rest
Rest is important to ensure that healing occurs as quickly as possible. You should rest the injured area for at least one or two days, because the bleeding can continue for up to 24 hours.
If possible, the sprained area should be kept straight - an arm, for example, can be supported in a sling. Try to keep the injured area in the same position while you are sleeping, perhaps by placing a couple of pillows under your sprain.
Ice
Since blood enters the tissues when you have a sprain, the main thing is to limit the bleeding. This can be done by cooling. Try the following techniques.
o Put ice cubes in a plastic bag, then place over the sprained area.
o In an emergency, use frozen vegetables in a bag.
o Use custom-made cooling-packets, which are bags containing a special jelly that can be chilled in your freezer.
In each case, wrap the cold bag in a towel before placing it on the sprain. Always put a piece of fabric between your skin and the coolant, otherwise your skin may get frostbite.
Stop the cooling long before your skin turns white or hard. Contact a doctor if your skin does not regain its usual colour after the process has stopped. It is a good idea to cool the skin for 15 minutes, stop for 15 minutes, then cool again, and so on.
Usually, the cooling is felt in different ways. This can range from cold to painful, burning and finally numbing.
Be careful if you are diabetic. To prevent damage to your blood circulation, do not cool an area without consulting your doctor.
Compression
You can also wrap bandages around the damaged area to prevent movement. Most people use a pressure bandage at first, followed by tape when the swelling has disappeared.
If you are wearing bandages, it is important to monitor the area surrounding them. If this becomes blue-coloured and the surrounding tissue seems cold, you should remove the bandages and contact a doctor.
Elevation
The injured area shouldn't point downwards, otherwise fluid build-up may occur. This prolongs the healing process and causes more pain.
How can I relieve the pain?
The most important treatment for a sprain is rest, ice, compression and elevation, as described above. However, the pain experienced following a sprain can also be relieved with over-the-counter painkillers, such as paracetamol (eg Panadol) or paracetamol and codeine (eg Panadol ultra).
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (eg Nurofen, Advil) used to be frequently recommended following a sprain, because they reduce the inflammation and swelling as well as relieving pain. However, inflammation is a necessary part of the healing process. It limits movement to prevent further damage to the joint and also initially helps to repair the damaged tissue. There is now some suggestion that reducing inflammation with this type of painkiller can actually slow down the healing process in the long-term. It may be best to avoid these types of painkillers in the first 24 to 48 hours after the injury.
When to consult a doctor ?
Ask yourself what caused your accident and focus on the cause. Note that the following information is a very rough guide: if in doubt, consult a doctor.
When the pain and the swelling have gone, start exercising the injured part of the body gently. After one or two days' rest, it is important to start moving again to reduce the amount of scarring formed in the damaged tissue.
As with any activity, warm up slowly and use stretching exercises to begin with. If it's possible to stay physically active without further injuring the sprained area, do so. Keep your other muscles functioning and maintain physical fitness.
How to treat bruises
Bruises and swellings are caused by bleeding under the skin. Again, bruises are best treated with cooling. To do this, follow the instructions given above for cooling treatment of sprains.
If several bruises surround a large one, and you have not had any other accidents, consult your doctor to find out whether your blood is clotting as it should.
Based on a text by Dr Hans Gad Johansen, specialist and Dr Ejnar Kuur, consultant
A sprain causes pain, swelling and discolouration (blue colouring). This happens because the small blood vessels and fibres in the flesh burst, causing blood to enter the surrounding tissue. This results in swelling and the blue colouring.
It is the same principle with a bruise: the skin is exposed to such a hard blow that the blood vessels break.
What should I do about a sprain?
If you have a sprain, you will also suffer pain. The injured area must be kept still or the bleeding in the tissue will continue more intensely. The most important treatment for a sprain is: rest, ice, compression, elevation (RICE).
Rest
Rest is important to ensure that healing occurs as quickly as possible. You should rest the injured area for at least one or two days, because the bleeding can continue for up to 24 hours.
If possible, the sprained area should be kept straight - an arm, for example, can be supported in a sling. Try to keep the injured area in the same position while you are sleeping, perhaps by placing a couple of pillows under your sprain.
Ice
Since blood enters the tissues when you have a sprain, the main thing is to limit the bleeding. This can be done by cooling. Try the following techniques.
o Put ice cubes in a plastic bag, then place over the sprained area.
o In an emergency, use frozen vegetables in a bag.
o Use custom-made cooling-packets, which are bags containing a special jelly that can be chilled in your freezer.
In each case, wrap the cold bag in a towel before placing it on the sprain. Always put a piece of fabric between your skin and the coolant, otherwise your skin may get frostbite.
Stop the cooling long before your skin turns white or hard. Contact a doctor if your skin does not regain its usual colour after the process has stopped. It is a good idea to cool the skin for 15 minutes, stop for 15 minutes, then cool again, and so on.
Usually, the cooling is felt in different ways. This can range from cold to painful, burning and finally numbing.
Be careful if you are diabetic. To prevent damage to your blood circulation, do not cool an area without consulting your doctor.
Compression
You can also wrap bandages around the damaged area to prevent movement. Most people use a pressure bandage at first, followed by tape when the swelling has disappeared.
If you are wearing bandages, it is important to monitor the area surrounding them. If this becomes blue-coloured and the surrounding tissue seems cold, you should remove the bandages and contact a doctor.
Elevation
The injured area shouldn't point downwards, otherwise fluid build-up may occur. This prolongs the healing process and causes more pain.
How can I relieve the pain?
The most important treatment for a sprain is rest, ice, compression and elevation, as described above. However, the pain experienced following a sprain can also be relieved with over-the-counter painkillers, such as paracetamol (eg Panadol) or paracetamol and codeine (eg Panadol ultra).
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (eg Nurofen, Advil) used to be frequently recommended following a sprain, because they reduce the inflammation and swelling as well as relieving pain. However, inflammation is a necessary part of the healing process. It limits movement to prevent further damage to the joint and also initially helps to repair the damaged tissue. There is now some suggestion that reducing inflammation with this type of painkiller can actually slow down the healing process in the long-term. It may be best to avoid these types of painkillers in the first 24 to 48 hours after the injury.
When to consult a doctor ?
- If the sprain is accompanied by severe pain and severe swelling.
- If one of your joints gives way and is unable to carry your weight.
- If the pain is still present after two days.
- If the sprain has not improved after four days of self-treatment.
Ask yourself what caused your accident and focus on the cause. Note that the following information is a very rough guide: if in doubt, consult a doctor.
- Running too quickly?
- Exercising without any warm-up or stretching exercises?
- Running, working out or playing sport without the proper shoes?
- Running on hard or uneven surfaces?
- Are any of your muscles overcompensating for weakness in another - for instance, due to a bad knee?
When the pain and the swelling have gone, start exercising the injured part of the body gently. After one or two days' rest, it is important to start moving again to reduce the amount of scarring formed in the damaged tissue.
As with any activity, warm up slowly and use stretching exercises to begin with. If it's possible to stay physically active without further injuring the sprained area, do so. Keep your other muscles functioning and maintain physical fitness.
How to treat bruises
Bruises and swellings are caused by bleeding under the skin. Again, bruises are best treated with cooling. To do this, follow the instructions given above for cooling treatment of sprains.
If several bruises surround a large one, and you have not had any other accidents, consult your doctor to find out whether your blood is clotting as it should.
Based on a text by Dr Hans Gad Johansen, specialist and Dr Ejnar Kuur, consultant
Sore throat :::
What is a sore throat?
A sore throat (also known as pharyngitis or tonsillitis) is a disease primarily located in the area around the tonsils. It can be caused by both a virus and a bacteria. A sore throat is partly a disease in itself and partly an effect of other diseases such as flu and glandular fever.
The disease is normally seen in children and young people but it can occur at any age. The characteristics of the disease are throat pain and trouble swallowing. If the disease is due to bacteria it can be treated with antibiotics. Usually there are no complications.
How do you contract a sore throat?
By being infected by a virus or bacteria.
Infection by a virus may come from the same virus that causes colds and from an Epstein-Barr virus - the latter causes glandular fever. The infection originates from airborne droplets and hands that carry the infection from person to person.
Among the bacteria that cause sore throats, the streptococcus group A is the most common. The incubation period between picking up the infection until the disease breaks out, is two to four days or sometimes less.
What are the signs of a sore throat?
* Pain in the throat and difficulty in swallowing.
* Pain may spread to the ears.
* The throat is reddish, the tonsils are swollen and may be coated.
* Possibly a high temperature.
* Swollen lymph nodes under your jaw and in your neck may occur.
* If the sore throat is due to a viral infection the symptoms are usually milder. Usually they are connected to the common cold.
* If the sore throat is due to the Coxsackie virus, small blisters may develop on the tonsils and in the soft palate. The blisters erupt in a few days and are followed by a scab which may be very painful.
* If the sore throat is due to a streptococcal infection, the tonsils often swell and become coated and the throat is sore. The patient runs a temperature, has sour breath and may feel quite ill.
How does the doctor make a diagnosis?
The doctor usually makes the diagnosis from the symptoms of the disease, but occasionally a swab of the secretions of the throat and maybe a blood sample are required to identify the cause.
What complications may arise?
Usually a sore throat causes no trouble and only lasts about a week, but the following complications may arise:
* a secondary infection may occur in the middle ear or sinuses.
* if the sore throat is due to a streptococcus infection, there may be a rash (scarlet fever).
* an uncommon complication is a throat abscess that usually occurs only on one side.
* in very rare cases, diseases like rheumatic fever or a particular kidney disease (glomerulonephritis) may occur.
How is a sore throat treated and which medication may help?
In the vast majority of cases, a sore throat cased by a virus infection need only be treated with paracetamol (eg Calpol, Panadol) to bring the temperature down.
In a small minority of patients, a sore throat caused by bacteria is treated with penicillin, or erythromycin (eg Erythroped) in cases of penicillin allergy.
The symptoms of a sore throat can be relieved by using over-the-counter medicines, such as sprays containing antiseptics and anaesthetics to numb the sore area, or antiseptic gargles. These can be bought without a prescription and your doctor or pharmacist will be able to advise you about them.
Based on a text by Dr Hanne Korsholm, GP
source netdoctor
A sore throat (also known as pharyngitis or tonsillitis) is a disease primarily located in the area around the tonsils. It can be caused by both a virus and a bacteria. A sore throat is partly a disease in itself and partly an effect of other diseases such as flu and glandular fever.
The disease is normally seen in children and young people but it can occur at any age. The characteristics of the disease are throat pain and trouble swallowing. If the disease is due to bacteria it can be treated with antibiotics. Usually there are no complications.
How do you contract a sore throat?
By being infected by a virus or bacteria.
Infection by a virus may come from the same virus that causes colds and from an Epstein-Barr virus - the latter causes glandular fever. The infection originates from airborne droplets and hands that carry the infection from person to person.
Among the bacteria that cause sore throats, the streptococcus group A is the most common. The incubation period between picking up the infection until the disease breaks out, is two to four days or sometimes less.
What are the signs of a sore throat?
* Pain in the throat and difficulty in swallowing.
* Pain may spread to the ears.
* The throat is reddish, the tonsils are swollen and may be coated.
* Possibly a high temperature.
* Swollen lymph nodes under your jaw and in your neck may occur.
* If the sore throat is due to a viral infection the symptoms are usually milder. Usually they are connected to the common cold.
* If the sore throat is due to the Coxsackie virus, small blisters may develop on the tonsils and in the soft palate. The blisters erupt in a few days and are followed by a scab which may be very painful.
* If the sore throat is due to a streptococcal infection, the tonsils often swell and become coated and the throat is sore. The patient runs a temperature, has sour breath and may feel quite ill.
How does the doctor make a diagnosis?
The doctor usually makes the diagnosis from the symptoms of the disease, but occasionally a swab of the secretions of the throat and maybe a blood sample are required to identify the cause.
What complications may arise?
Usually a sore throat causes no trouble and only lasts about a week, but the following complications may arise:
* a secondary infection may occur in the middle ear or sinuses.
* if the sore throat is due to a streptococcus infection, there may be a rash (scarlet fever).
* an uncommon complication is a throat abscess that usually occurs only on one side.
* in very rare cases, diseases like rheumatic fever or a particular kidney disease (glomerulonephritis) may occur.
How is a sore throat treated and which medication may help?
In the vast majority of cases, a sore throat cased by a virus infection need only be treated with paracetamol (eg Calpol, Panadol) to bring the temperature down.
In a small minority of patients, a sore throat caused by bacteria is treated with penicillin, or erythromycin (eg Erythroped) in cases of penicillin allergy.
The symptoms of a sore throat can be relieved by using over-the-counter medicines, such as sprays containing antiseptics and anaesthetics to numb the sore area, or antiseptic gargles. These can be bought without a prescription and your doctor or pharmacist will be able to advise you about them.
Based on a text by Dr Hanne Korsholm, GP
source netdoctor
Nosebleeds in children :::
What causes nosebleeds?
A nose starts to bleed when one of the small veins in its lining bursts. This is usually caused by something completely harmless, such as the child picking their nose, blowing it too hard or having their nose knocked while playing.
Another reason could be that the child has pushed something inside their nose.
How should nosebleeds be treated?
A nosebleed can be a very traumatic event for the child. They will often be scared and think something is seriously wrong with them because there is so much blood. So it is important that the parent stays calm. They should cuddle the child and say something reassuring, like, 'It's OK, let's sit down, then you'll be fine. I'm here and I'll make sure you're OK.'
Holding the nose presses directly on the bleeding vein. This stops the bleeding and the blood will then coagulate or thicken into a scab.
Why should the child sit down?
Bleeding will stop faster if the child is sitting instead of lying down. It used to be recommended that a person with a nosebleed should lie down, but that makes the blood pressure in the head increase.
When the blood pressure goes up, more blood is pumped through the veins, which will make the nose bleed more and the nosebleed harder to stop.
Also if you lie back, blood will run down your throat. If the child swallows a lot of blood, they will vomit.
Why do some children get nosebleeds more often than others?
Some children have veins that are closer to the mucous membrane of their nose than other children. Because the veins are very close to the skin, they are more likely to burst when the child picks, blows or rubs their nose, or plays rough games.
Some children pick their nose a lot so they too are more likely to get nosebleeds. Cut the child's nails frequently. A little petroleum jelly applied on the inner side of the nose can also soften scabs.
If the child often gets nosebleeds, it may be a good idea to have a doctor examine them.
If the nosebleeds are caused by a vein that is very close to the skin, they can be prevented by cauterising the front of the nose. This is a simple procedure that can be carried out in the GP's surgery or hospital clinic.
How should you remove a foreign body from a child's nose?
If the child has put a foreign body up their nose, let a doctor remove it. Children are capable of putting the most surprising objects up their noses. It is best to have the doctor remove the object to avoid the risk of pushing it up further.
Are nosebleeds dangerous?
If the child often gets nosebleeds, or nosebleeds that are hard to stop, have a doctor examine the child. Children do not come to any serious harm from nosebleeds. Rarely, the bleeding may be due to a problem that prevents the child's blood clotting properly. This can be confirmed by a blood test.
When should the doctor be called in the case of nosebleed?
source : netdoctor
A nose starts to bleed when one of the small veins in its lining bursts. This is usually caused by something completely harmless, such as the child picking their nose, blowing it too hard or having their nose knocked while playing.
Another reason could be that the child has pushed something inside their nose.
How should nosebleeds be treated?
A nosebleed can be a very traumatic event for the child. They will often be scared and think something is seriously wrong with them because there is so much blood. So it is important that the parent stays calm. They should cuddle the child and say something reassuring, like, 'It's OK, let's sit down, then you'll be fine. I'm here and I'll make sure you're OK.'
- When the child is sitting down, hold their nostrils with your fingers, a handkerchief or a facecloth.
- Pinch the lower, soft part of the nose between the thumb and forefinger.
- The grip should be firm and the pressure on the nose steady.
- Hold the child's nose for 10 minutes. Look at a watch so you are sure 10 minutes have passed before letting go.
- If the child is old enough, teach them how and where to hold their own nose.
- If in doubt, have the doctor or health visitor show you how to hold the nose.
- It may be a good idea to read a story or watch television while waiting, to divert the child's attention.
- After the nosebleed has stopped, the child should not play any rough games for a couple of hours to prevent the nosebleed starting again.
- Tell the child not to pick, rub or blow their nose for a couple of days.
- If the bleeding continues, try the same procedure once more.
- If the bleeding doesn't stop, call the doctor.
Holding the nose presses directly on the bleeding vein. This stops the bleeding and the blood will then coagulate or thicken into a scab.
Why should the child sit down?
Bleeding will stop faster if the child is sitting instead of lying down. It used to be recommended that a person with a nosebleed should lie down, but that makes the blood pressure in the head increase.
When the blood pressure goes up, more blood is pumped through the veins, which will make the nose bleed more and the nosebleed harder to stop.
Also if you lie back, blood will run down your throat. If the child swallows a lot of blood, they will vomit.
Why do some children get nosebleeds more often than others?
Some children have veins that are closer to the mucous membrane of their nose than other children. Because the veins are very close to the skin, they are more likely to burst when the child picks, blows or rubs their nose, or plays rough games.
Some children pick their nose a lot so they too are more likely to get nosebleeds. Cut the child's nails frequently. A little petroleum jelly applied on the inner side of the nose can also soften scabs.
If the child often gets nosebleeds, it may be a good idea to have a doctor examine them.
If the nosebleeds are caused by a vein that is very close to the skin, they can be prevented by cauterising the front of the nose. This is a simple procedure that can be carried out in the GP's surgery or hospital clinic.
How should you remove a foreign body from a child's nose?
If the child has put a foreign body up their nose, let a doctor remove it. Children are capable of putting the most surprising objects up their noses. It is best to have the doctor remove the object to avoid the risk of pushing it up further.
Are nosebleeds dangerous?
If the child often gets nosebleeds, or nosebleeds that are hard to stop, have a doctor examine the child. Children do not come to any serious harm from nosebleeds. Rarely, the bleeding may be due to a problem that prevents the child's blood clotting properly. This can be confirmed by a blood test.
When should the doctor be called in the case of nosebleed?
- If there's a chance the child's nose may be broken.
- If the bleeding can't be stopped (how to stop a nosebleed is described above).
- If the child frequently gets nosebleeds that take more than 15 minutes to stop.
- If the child has trouble breathing.
- If the child is bleeding elsewhere, for example from their ears or gums.
- If the child has a foreign body stuck up their nose.
source : netdoctor
Headlice and nits :::
What are lice?
The head louse is a tiny greyish-brown insect, about 2.5mm long.
Head lice cling to hair and are usually found on the scalp. They live on blood from the host, which they get by biting through the scalp.
Adult lice mate. The female then lays eggs that are firmly attached to hair close to the scalp and can be very difficult to remove.
After seven or eight days the baby louse hatches out of the egg, leaving a shiny white empty eggshell (nit), which may be found anywhere along a strand of hair.
What causes an infection of head lice?
Infection with head lice is a very common problem in the UK, especially among school children.
Lice pass from one person to another during direct head-to-head contact. This is because lice cannot jump, fly or hop; they can only transfer to another head by walking along strands of hair.
Children whispering secrets at school or families enjoying a cuddle at home provide head lice with the ideal opportunity to travel from one head to the next.
Lice seen on pillows, hats or chair backs are not capable of transferring to another person.
The belief that head lice are associated with poor hygiene is common but misfounded. Lice are equally likely to be found on clean or dirty hair.
Head lice should be seen as nothing more than an unpleasant inconvenience that can be treated.
What symptoms do head lice cause?
Bites from head lice can cause intense itching and irritation on the scalp, but these symptoms may not appear until at least two months after the lice move in. A rash at the nape of the neck may also develop.
What is the best way of looking for head lice?
You can part the hair and look for nits, but the lice will move quickly into hiding.
The best way to search for head lice and nits is to buy a specially designed detection (nit) comb from a pharmacy. This is a fine-toothed plastic comb with spacing of less than 0.3mm.
You can check for lice on dry or wet hair.
People with thick hair often find conditioner makes it easier to get the nit comb through. If you have curly hair you may find that oiling rather than wetting hair makes it easier to use the nit comb effectively. You can do this with one tablespoonful of olive oil.
What if I find lice?
Check every other member of the family, including any adults who have close contact with the child.
You can work out when the lice first moved in by judging how many centimetres from the scalp you find the nits. Hair grows at about 1cm a month; so a nit 2cm from the scalp was laid about two months ago.
It's also helpful to tell the school and parents of any other child who may have had head-to-head contact with your child, so that other children can be checked for lice.
How are head lice treated?
The three main treatments for head lice are listed below, but no method is 100 per cent effective.
You should only start chemical treatment if you find a live louse on your child's head. If you only find the hatched and empty eggshells (nits), these may be the sign of a previous batch of lice that have already been eradicated.
Insecticides
Insecticides that kill head lice are available in lotion, mousse and shampoo form. You can buy them from the pharmacy or get them on prescription.
There are three types available in the UK:
* malathion (Derbac-M liquid, Prioderm lotion and Quellada-M liquid)
* permethrin (Lyclear crème rinse)
* phenothrin (Full Marks liquid or lotion).
For them to work, you must follow the manufacturer's instructions to the letter.
Treatment failures may result from not using the product in the correct way, for example:
After applying the lotion leave the hair to dry naturally. Do not use a hair dryer because the heat may alter the lotion and prevent it from working effectively.
Lice eggs are more difficult to kill because the insecticide may not be able to penetrate the eggshell. You will need to repeat the treatment after seven days to kill any lice from eggs that survived the first application.
Unfortunately there is evidence that head lice are becoming resistant to some of the insecticides. There are also concerns about the environmental effects of overusing insecticide preparations (which are the same as some agricultural pesticides in general use).
There are a number of herbal products such as tea tree oil and neem seed oil, and methods such as electric combs, which have been suggested as treatments for head lice.
You can also buy sprays to prevent head lice.
As yet, no good medical trials have shown that these treatments are effective.
Written by Dr Gillian Rice, GP
The head louse is a tiny greyish-brown insect, about 2.5mm long.
Head lice cling to hair and are usually found on the scalp. They live on blood from the host, which they get by biting through the scalp.
Adult lice mate. The female then lays eggs that are firmly attached to hair close to the scalp and can be very difficult to remove.
After seven or eight days the baby louse hatches out of the egg, leaving a shiny white empty eggshell (nit), which may be found anywhere along a strand of hair.
What causes an infection of head lice?
Infection with head lice is a very common problem in the UK, especially among school children.
Lice pass from one person to another during direct head-to-head contact. This is because lice cannot jump, fly or hop; they can only transfer to another head by walking along strands of hair.
Children whispering secrets at school or families enjoying a cuddle at home provide head lice with the ideal opportunity to travel from one head to the next.
Lice seen on pillows, hats or chair backs are not capable of transferring to another person.
The belief that head lice are associated with poor hygiene is common but misfounded. Lice are equally likely to be found on clean or dirty hair.
Head lice should be seen as nothing more than an unpleasant inconvenience that can be treated.
What symptoms do head lice cause?
Bites from head lice can cause intense itching and irritation on the scalp, but these symptoms may not appear until at least two months after the lice move in. A rash at the nape of the neck may also develop.
What is the best way of looking for head lice?
You can part the hair and look for nits, but the lice will move quickly into hiding.
The best way to search for head lice and nits is to buy a specially designed detection (nit) comb from a pharmacy. This is a fine-toothed plastic comb with spacing of less than 0.3mm.
You can check for lice on dry or wet hair.
- Use a brush or an ordinary comb to first detangle hair.
- Once hair has been detangled, switch to the detection comb.
- Start at the middle of the front of the scalp.
- Comb the hair from the roots to the very end of the hair.
- After each stroke, examine the teeth of the comb for living lice.
- Rinse the comb if you find any lice.
- Continue combing section by section until you've done the whole head of hair.
- Make sure you cover every inch of the scalp, including the area just behind the ears and at the nape of the neck.
People with thick hair often find conditioner makes it easier to get the nit comb through. If you have curly hair you may find that oiling rather than wetting hair makes it easier to use the nit comb effectively. You can do this with one tablespoonful of olive oil.
What if I find lice?
Check every other member of the family, including any adults who have close contact with the child.
You can work out when the lice first moved in by judging how many centimetres from the scalp you find the nits. Hair grows at about 1cm a month; so a nit 2cm from the scalp was laid about two months ago.
It's also helpful to tell the school and parents of any other child who may have had head-to-head contact with your child, so that other children can be checked for lice.
How are head lice treated?
The three main treatments for head lice are listed below, but no method is 100 per cent effective.
You should only start chemical treatment if you find a live louse on your child's head. If you only find the hatched and empty eggshells (nits), these may be the sign of a previous batch of lice that have already been eradicated.
Insecticides
Insecticides that kill head lice are available in lotion, mousse and shampoo form. You can buy them from the pharmacy or get them on prescription.
There are three types available in the UK:
* malathion (Derbac-M liquid, Prioderm lotion and Quellada-M liquid)
* permethrin (Lyclear crème rinse)
* phenothrin (Full Marks liquid or lotion).
For them to work, you must follow the manufacturer's instructions to the letter.
Treatment failures may result from not using the product in the correct way, for example:
- if not enough lotion is applied to the head. At least one small bottle (50-55ml) is required to treat a single head. Young children and those with thinner hair may need less, but long thick hair may require more.
- tipping all the lotion on the top of the scalp and attempting to spread it from there. You are more likely to spread the lotion evenly along the length of the hair if you make a small parting and apply a few drops along the hair. Repeat this process with other small sections until the whole scalp has been covered.
After applying the lotion leave the hair to dry naturally. Do not use a hair dryer because the heat may alter the lotion and prevent it from working effectively.
Lice eggs are more difficult to kill because the insecticide may not be able to penetrate the eggshell. You will need to repeat the treatment after seven days to kill any lice from eggs that survived the first application.
Unfortunately there is evidence that head lice are becoming resistant to some of the insecticides. There are also concerns about the environmental effects of overusing insecticide preparations (which are the same as some agricultural pesticides in general use).
- Dimeticone
Dimeticone (Hedrin) is a silicone-based lotion. It's a relatively new product, having launched in 2006, and works in a different way to conventional insecticides for head lice.
Instead of poisoning the parasites by chemical means, the dimeticone coats and smothers the lice. This prevents the lice from excreting excess water, killing them.
After applying the lotion the hair should be left to dry naturally.
The lotion doesn't kill eggs, so you need to repeat treatment after seven days to kill any lice that have hatched from eggs since the first application.
- Wet combing
Wet combing removes lice without using chemicals.
It involves wetting the hair, applying conditioner, then combing it with a fine-toothed comb for at least 30 minutes every third or fourth day over a two-week period.
The aim is to remove any live lice and eggs until none are left.
A 2005 study found wet combing more effective than insecticides at curing head lice infestations. The Bug Busting kit used in the study is available on prescription.
There are a number of herbal products such as tea tree oil and neem seed oil, and methods such as electric combs, which have been suggested as treatments for head lice.
You can also buy sprays to prevent head lice.
As yet, no good medical trials have shown that these treatments are effective.
Written by Dr Gillian Rice, GP
Fever in children :::
What is Fever ?
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). The temperature is measured with a thermometer.
Source : Dictionary of Medicine (Shahram)
Temperature control in the body
The 'core temperature' means the temperature of the deep tissues of the body and in normal circumstances this is kept at a very even level by a range of automatic adjustments.
When we are too hot we increase the amount of blood flowing through the skin by opening up the tiny capillary blood vessels. This radiates away excess heat and sweating can further enhance this.
When we are too cold we shut down skin blood vessels and conserve heat within the internal organs. If necessary we can generate more heat by shivering.
Fever is part of the body's defence mechanism against viruses or bacteria. The body tries to create extra heat so that the foreign organism cannot survive. Having a temperature helps you fight illness.
Actions to reduce a fever can help make someone feel more comfortable but it is not possible, or desirable, to aim to normalise the temperature while someone is fighting off an infection.
The part of the human brain that controls body temperature is not fully developed in children. This means that a child’s temperature may rise and fall very quickly and the child is sensitive to the temperature of his or her surroundings.
One of the simplest and most effective ways to help a child with a fever feel more comfortable is to take off some of the child's clothes so heat can escape from their body more easily.
What is the normal temperature for a child?
If you take the temperature in your child's mouth or from the ear, the normal temperature is 36-36.8ºC (97.7-99.1ºF).
Thermometers
Traditional mercury thermometers are being phased out although many are still around. Mercury is a highly toxic substance if taken into the body, which can be done through skin contact, breathing in the vapour or swallowing it.
All these risks can apply to the fragile glass thermometer if it is broken, for example by a child biting it.
If you have a mercury thermometer, check with your local council how to dispose of it safely.
Modern probe-type digital thermometers are quicker to use, more reliable and are much safer if bitten.
Taking a child's temperature
A body temperature reading can be taken from the mouth, armpit, ear, skin surface or the rectum.
Although a rectal temperature reading is the most accurate and is quite often used in hospital it is not necessary to be so precise when taking temperature readings at home. Rectal temperature reading is therefore not recommended for home use.
Rectal temperatures are the closest to 'core' temperature and are about 0.5ºC (2ºF) higher than readings taken from the mouth or ear.
Temperature readings from the armpit are not very reliable and are about 0.5ºC lower than mouth temperature.
Thermometer strips that are placed on the child's forehead are popular and give a rough guide.
Most of the time the exact level of a child’s temperature is not particularly important, unless it is very high (39ºC or over).
In practical terms the temperature reading will be enough to give an indication of whether a fever is present.
Liquids
A child with a high temperature needs more liquid than usual, because the fever will make them sweat a lot.
Make sure your child drinks plenty of liquids - a teaspoonful every few minutes, if necessary. Provided they drink plenty of liquids, it won't matter too much if they eat very little for a couple of days.
Look at your child and use common sense. Do they look exhausted or ill? Are they behaving differently? If the answer is yes, call the doctor. You should also call your doctor if:
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). The temperature is measured with a thermometer.
Source : Dictionary of Medicine (Shahram)
Temperature control in the body
The 'core temperature' means the temperature of the deep tissues of the body and in normal circumstances this is kept at a very even level by a range of automatic adjustments.
When we are too hot we increase the amount of blood flowing through the skin by opening up the tiny capillary blood vessels. This radiates away excess heat and sweating can further enhance this.
When we are too cold we shut down skin blood vessels and conserve heat within the internal organs. If necessary we can generate more heat by shivering.
Fever is part of the body's defence mechanism against viruses or bacteria. The body tries to create extra heat so that the foreign organism cannot survive. Having a temperature helps you fight illness.
Actions to reduce a fever can help make someone feel more comfortable but it is not possible, or desirable, to aim to normalise the temperature while someone is fighting off an infection.
The part of the human brain that controls body temperature is not fully developed in children. This means that a child’s temperature may rise and fall very quickly and the child is sensitive to the temperature of his or her surroundings.
One of the simplest and most effective ways to help a child with a fever feel more comfortable is to take off some of the child's clothes so heat can escape from their body more easily.
What is the normal temperature for a child?
If you take the temperature in your child's mouth or from the ear, the normal temperature is 36-36.8ºC (97.7-99.1ºF).
Thermometers
Traditional mercury thermometers are being phased out although many are still around. Mercury is a highly toxic substance if taken into the body, which can be done through skin contact, breathing in the vapour or swallowing it.
All these risks can apply to the fragile glass thermometer if it is broken, for example by a child biting it.
If you have a mercury thermometer, check with your local council how to dispose of it safely.
Modern probe-type digital thermometers are quicker to use, more reliable and are much safer if bitten.
Taking a child's temperature
A body temperature reading can be taken from the mouth, armpit, ear, skin surface or the rectum.
Although a rectal temperature reading is the most accurate and is quite often used in hospital it is not necessary to be so precise when taking temperature readings at home. Rectal temperature reading is therefore not recommended for home use.
Rectal temperatures are the closest to 'core' temperature and are about 0.5ºC (2ºF) higher than readings taken from the mouth or ear.
Temperature readings from the armpit are not very reliable and are about 0.5ºC lower than mouth temperature.
Thermometer strips that are placed on the child's forehead are popular and give a rough guide.
Most of the time the exact level of a child’s temperature is not particularly important, unless it is very high (39ºC or over).
In practical terms the temperature reading will be enough to give an indication of whether a fever is present.
- Ear temperature
- To get a reliable temperature measurement, the thermometer must be used exactly as directed.
- When you buy the thermometer, ask the salesperson how to use it, and read the instructions carefully before you start.
- Especially with small children, ear thermometers require a steady hand to find the right spot.
- The ear canal has a natural curve, so to ensure that the thermometer is pointing towards the eardrum it may be necessary to pull the top part of your child's ear gently upwards during the reading.
- If your child has been lying with their head on a warm pillow, or has just come inside out of the cold, you will need to wait 10 to 15 minutes before the ear can provide an accurate measurement of body temperature.
If you are willing to pay for an ear thermometer, this is a very quick method and will give a read-out in seconds. Ear thermometers rely on measuring infrared (heat) radiation from the eardrum.
Other types of thermometer (such as the probe type) are not suitable for taking ear readings and must never be placed within the ear canal.
Some ear thermometers are adjustable so they can be made suitable for adults or children.
- Under the armpit
- With children old enough to co-operate and keep still you need to keep the thermometer under their armpit for at least 5 minutes.
This method is not good for small children, since they will not stay still for long enough.
- From the mouth
- The thermometer is placed in the mouth, under the tongue.
- It will take two to three minutes to measure the temperature accurately.
- If your child has just eaten anything hot or cold, you will need to wait 10 minutes before an accurate temperature can be taken.
This method is not suitable for a young child, because they may bite the thermometer and break it.
Liquids
A child with a high temperature needs more liquid than usual, because the fever will make them sweat a lot.
Make sure your child drinks plenty of liquids - a teaspoonful every few minutes, if necessary. Provided they drink plenty of liquids, it won't matter too much if they eat very little for a couple of days.
- Rest
A child with a high temperature also needs rest and sleep. They do not have to be in bed all day if they feel like playing, but they must have the opportunity to lie down.
- Body temperature
You do not sweat out a fever. If your child shivers while their temperature is rising, it's okay to cover them with a duvet or a blanket. But as soon as your child's temperature has stabilised and he or she starts sweating, they need to cool down.
Your child only needs to wear underwear or a nappy, which will help the heat escape from the body. Make sure their room is ventilated and cool, but not draughty.
- Medicines
If you want to use medication to get the temperature down, ask your doctor or pharmacist. They will be able to tell you what to use and how much. The dosage will depend on both the age and weight of your child.
Paracetamol suspension (eg Calpol) is the usual choice and ibuprofen (eg Nurofen for children) is an alternative. Aspirin should not be given to children under 16 years of age.
- Attention
Sick children are often tired and bad-tempered. They sleep a lot and when they are awake; they want their parents around all the time. They might whine and act younger than their age.
It is okay to give in and spoil a child a little when they are sick. Read to them, play with them and spend time with them. This is not the time to teach a child good manners.
A child usually recovers quickly and will go back to their old self again.
Look at your child and use common sense. Do they look exhausted or ill? Are they behaving differently? If the answer is yes, call the doctor. You should also call your doctor if:
- you have a young child, less than three months old, who runs a high fever.
- your child cries and cries, without you being able to comfort them, and doesn't wake up easily.
- your child has a temperature over 38ºC (101.3ºF) for more than three days.
- your child has just had an operation.
- your child doesn't seem to be getting better.
- Stiff neck.
- Affected by bright light.
- Hallucinations.
- Red rash or blue/purple dots or patches.
- Trouble breathing.
- Cramps.
- Continued vomiting or diarrhoea.
- Continued tonsillitis.
- Pain when urinating, or urinating more than usual.
- Other illnesses.
Written by Dr Stuart Crisp, paediatric specialist registrar and Dr Per Grinsted, specialist
Source : NetDoctor
Source : NetDoctor
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