Minor Ailments - Travel health Flashcards
1
Q
What to consider about travel health?
A
- Mode of transport= air,car, sea
- Length of journey = how long they need th med to work for
- Destination= Especially for malaria you need to know the risk of malaria
- Length of stay = How much med do you need to give
- Purpose of trip = Vist fmaily , volunteering
- Accommodation = tent , hotel (affects mosquitoe exposure)
- Travel health risk assessment – 6-8 weeks before travel – need for vaccines, malaria prophylaxis
2
Q
what patinet groups are high risk?
A
- Children= most likely to be hospitalised
- Elderly = jetlagged
- Pregnant women = generally recommendation you can travel upo to 36 weeks
In air= increase risk of clots
S/ airlines want preg women to present certificates for when due date is - Immunocompromised= increases risk of infections
- Health conditions e.g. respiratory, renal/hepatic
impairment, diabetics = Need to have enough supply
2
Q
What is Travel sickness?
A
- v/ common
- sickness when travelling due to brains inability to process conflicting sensory information = Regarding movement & position there is conflicting info so patient becomes nauseous
- Can affect anyone on any mode of transport,
more common in young children, women and
migraine sufferers - Symptoms: nausea, vomiting, dizziness, sweating, drowsiness, headache, pallor
2
Q
How to manage travel sickness? (1)
A
- Ideally stop motion causing sickness= not always possible
- Prevent travel sickness by taking medication prior to travel
- Choice based on length of journey/duration of action
- Sedating antihistamines e.g. Cinnarizine 15mg tablets (P),= 2 tablets 2hrs before travel (really long journey = repeat dose after 8hrs)
Promethazine 25mg tablets (P),= 1 the night before or 1-2 hrs before, for longer journeys 4-8 hours - Anticholinergic e.g. Hyoscine hydrobromide 300mcg tablets (P), most effective, short journey up to 4 hours. = Quick acting take 20-30 mins before = most common + effective
- Caution – closed angle glaucoma= rise in eye pressure
- Acupressure bands = limited evidence
- Ginger - tea, biscuits, tablets – more effective than placebo
3
Q
Sun protection
A
- Sun exposure natural way of getting vitamin D and elevates mood
- Sun damages skin by ultraviolet (UV) radiation , UVA rays cause skin tanning and UVB rays cause skin burn
- Skin cells, melanocytes produce melanin on exposure to UV light which causes darkening of skin
- UV radiation main cause of skin cancers, damages DNA within skin cells
- Avoid excessive skin exposure, highest risk of damage when sun strongest, 11am – 3pm
- Wear sunglasses, hat with brim, long sleeved tops
3
Q
What can you do to manage travel sickness?
A
- Distract yourself
- Limit motion – front seat/middle of boat
- Breath fresh air – open car windows
- Look ahead, focus on horizon
- Focus on slow breathing
- Stop for breaks on longer journeys
- Avoid looking at moving cars
- Avoid eating heavy meals or drinking alcohol prior and during travel
- Avoid reading, focusing on electronic devices
- For dry mouth = suck on sweets
4
Q
What is sunburn?
A
- Inflammatory response to excessive UV radiation that damages the skin, usually settles within 7 days
- Duration of exposure, sunscreen usage, severity
- Symptoms: skin becomes red, hot to touch, sore, peels away after few days
- Severe = you get blisters
- Large blisters = refer
- Self care – get out of sun exposure, cool skin by coldshower/bath/compress, drink plenty of cool fluids, apply aftersun cream or aloe vera gel, leave blisters intact ( popping increases risk of infection) , pain relief – paracetamol or ibuprofen
- Sunburn causes premature aging of the skin
5
Q
Sunscreens
A
- Products that protect against skin damage caused by sun’s UV radiation
- ‘SPF’ sun protection factor, shows protection against UVB rays, SPF 50+ provides highest protection
- ‘SPF’ is the amount of time taken to get sunburn versus skin alone
e.g. if you get sunburn in 10 mins of sun exposure, after applying SPF50 = 50 x10mins = it should take 500 mins to sunburn hence protected for 50 times longer - UVA star rating ranges from 0 to 5, shows UVA radiation absorbed by sunscreen compared to UVB, 5 stars provides highest protection
- Apply generously, to all areas of skin that are exposed, apply 20-30 mins before sun exposure, reapply if go into water, apply before insect repellants/moisturisers
6
Q
What is Travellers’ Diarrhoea?
A
- Passing unformed stools 3 or more times in 24 hours with either abdominal pain, nausea/vomiting, fever
- Mainly caused by bacteria usually Escherichia coli, Campylobacter, Salmonella and Shigella, spread by consumption of contaminated food or water
- Increased risk in less developed countries, poor
hygiene = contamination of food & water - Usually occurs in first week of travel
- Advise hand hygiene, food hygiene and drinking clean water
7
Q
How to manage travellers’
diarrhoea?
A
- Self-limiting, usually lasts 3-5 days
- Prevent dehydration – drink plenty of fluids especially young/elderly
- Oral rehydration salts e.g. Dioralyte sachets (GSL/P), O.R.S tablets
- Mild/moderate symptoms: Antimotility drug e.g. Loperamide = = 2 straight away then 1 after each bowel movement(Imodium) (GSL/P), (over 12 years)- short term
- Antibiotic use not routinely recommended
- Prophylaxis in high risk patients – Ciprofloxacin (POM) - as a precaution
- Self care – wash hands with soap and water, drink bottled water, cook food thoroughly
8
Q
Preventative measures for DVT
A
- Move around as much as possible ( sit in seat nearest to aisles so you can get up & walk)
- Do calf exercises
- Stay well hydrated
- Avoid excessive alcohol
- Increased risk - Anti embolism stockings/graduated compression stockings/flight socks
- Aspirin not recommended for prophylaxis of
travel DVT/PE
9
Q
What is Deep Vein Thrombosis (DVT)?
A
- Long distance travel - on flight from sitting to long , increased periods of immobility, slower blood flow increases risk of blood clots in a deep vein
- Pulmonary embolism (PE) – blood clot blocks blood vessel in lungs
- Risk factors – history of DVT/PE, heart/lung disease, over 60 years old, obesity, pregnancy + if patients take combined oral contraceptive pill can cause DVT
- Symptoms of DVT: redness, swelling in 1 leg, warm skin, throbbing pain in 1 leg, swollen hard veins
- Symptoms of PE: difficulty breathing, chest pain, coughing up blood
- Seek immediate help
10
Q
What is Malaria?
A
- Parasitic infection transmitted to humans by a bite of an infected female anopheles mosquito
- Blood transfusion from infected individual can cause malaria
- Generally bite between sunset and sunrise
- Mainly occurs in tropical regions, majority of cases in Africa
- Preventable and curable if diagnosed and treated promptly
- Potentially life-threatening disease - 1500 uk reported annually
- Risk of severe disease for pregnant women, children, elderly, immunocompromised = severe complications
10
Q
‘ABCD’ of Malaria Prevention
A
- Travellers are advised to follow ABCD approach to prevent malaria
A – Awareness of risk = know whether the areas they are travelling to are high or low risk
B – Bite prevention = not bitten = no malaria
C – Chemoprophylaxis – use of appropriate malaria prevention tablets
D – Diagnosis – prompt diagnosis and treatment - Make them aware of the symptoms so they can seek treatment 7 be aware
11
Q
Malaria prophylaxis
Awareness of risk
A
- Country specific malaria prophylaxis guidance resources:
- UK Health Security Agency - Advisory Committee on Malaria Prevention (ACMP)
- NaTHNaC/Travel Health Pro
- BNF
- Community pharmacy chains
- www.gov.uk foreign travel advice
- NHS Fitfortravel
- Stick to one resource for consistency of advice & guide patient using that one resource
12
Q
ACMP
A
18
Q
Anit- malarial drugs ( chemoprophylaxis)
A
