Responding To Symptoms IPM Flashcards
What is the ASMETHOD
Adult or Child? Self or Someone Else Medication (regularly taken or Rx or OTC) Extra Medicines Time Persisting History Other Symptoms Danger Symptoms
Ear infections symptoms include..
Pain, Discharge, Fever, Itch, Hearing loss, Dizziness/Imbalance
List some Ear Specific questions
- Any history of ear injury? (can occur with inserting cotton bud)
- History of ear problems?
- Are you suffering form any other illness e.g cough, cold, sore throat.
What conditions do we need to eliminate with earache?
Earache with fever, vomit, severe deafness, children below 6 with ear pain.
Whats easy to be infected after ear is infected? What age group is most affected from getting ear infections?
Throat. Most common in children before age 3
Whats the name of the tube leading to the back of the throat from the ear?
eustachian tube
OTC Treatment available
- Cerumenolytics (soften the cerumen, wax)
- Docusate Sodium (e.g Waxol - it softents te cerumen)
- Olive/Almond oil
- Irrigation/syringe: use warm water
- Peroxide-based (e.g Otex, breaks up hardened wax)
Where can bacterial/fungal ear infections be acquired
Caught through swimming
OTC Treatment for ear infection other than the common ones given to soften ear wax?
Analgesics!
Ear Calm Spay (Contains Acetic acid which has antimicrobial effects, by making the environment acidic and difficult to survive)
Self Care advice after Ear OTC treatment?
Swim ear plugs, ear drops, shower, use swim cap, dry your ears after a swim
Prescription Ear Treament
Chloramphenicol ear drops.
Antifungal Ear drops e.g Clomitrazole Solution
Aluminium Acetate + ribbon gauze dressing
Counselling on administering ear drops?
Wash hands, ten shake the bottle and remove the cap
Tilt head to one side so affected ear is upwards
Pull ear lobe to straighten ear canal
Instil required number + keep tilted for 5-10 min
Discard after 28 days. Write date of opening
Conjunctivitis has 3 stypes. These are..
Irritant - Allergic - Infective
State two key eye complications (not conjunctivitis)
- Styes
- Blepharitis
Important Eye questions are:
Do you wear contact lenses? Are there any visual disturbances? Are you Diabetic? Are you unwell? Pain? PMH
Infective Conjunctivitis can be either
Bacterial or viral
Presenting features of Bacterial Conjunctivitis
muco-purulent sticky discharge, eyelashes have crusty discharge
Presenting Features of Viral Conjunctivitis
Watery, Red eye, Very intensive and photophobia
Other broad features of both viral and bacterial conjunctivitis
sore, burning, swollen, irritated and contagious (infects both eyes)
Features of Allergic detmatitis
Seasonal
when to refer a patient with suspected conjunctivitis
Pain in eyes/ Disturbed vision, Acute glaucoma, eye surgery (lasts 6 months)
Children below age of 2 years
OTC treatment failure
Conjunctivitis at risk groups include
Children/Elderly/Newborn
Immunosuppressed Px
Diabetic
Treatment of bacterial conjunctivitis and viral conjunctivitis
NO Treatment for viral OTC
10mL Chloramphenicol 0.5% eye drops. Store in fridge at 2-8°C
or 4g Chloramphenicol 1% eye ointment..
Treatment of Allergic Conjunctivitis
Antihistamines/Sodium Chromoglycate/ Intra ocular eye drops/ nasal spray
Irritant Conjunctivitis Tx
Witch Hazel (Optrex sore eyes)
Self care for infective conjunctivitis
- contact work or school (for adult or child)
- avoid contact lenses
- avoid rubbing in eyes, wash hands regularly
- Cold compress and avoid sharing towels. Wash with high temperatures.
Self care for irritant conjunctivitis
Sunglasses to avoid the glare.
Computer rest breaks
Key points for all eye drops and ear products when opened
- Discard after 28 days
- Check for compatibility with contact lenses
- Write ‘date of opening’ on label to remember
What do styles look like?
small pimple/boil in or on outside of eyelid
painful lump
pus
self limiting 1-3 weeks
Stye Treatment?
Warm Compress and Analgesics
