Choosing well

1. Choosing well • The most appropriate source of help and how to decide • Some common problems and what we may be able to do to help ourselves

2. For which of these would you call 999? • Bitten by a hamster? • Bunny ears? • Man U losing in the premier league? • Sudden onset drooping of the face? • All of them?

3. FAST

4. Cough

5. Calling 999 • If you think you are having a stroke or heart attack

6. Calling 999 • Loss of consciousness • Acute confused state and fits that are not stopping • Severe injury

7. Calling 999 • Breathing difficulties • Severe bleeding that can't be stopped

8. Calling 999 • Severe burns or scalds • Choking • Collapse

9. Calling 999 • Ask for the ambulance service • Tell them: The address where the person is Who is ill How old they are The telephone number you are calling from

10. Is the person awake? Calling 999What has happened • Is the person breathing?

11. Have they got any chest pain? Calling 999 • Is the person bleeding?

12. When to go to A&E • Severe abdominal pain • Severe allergic reactions • Any significant injury • Overdoses

13. When you might have to call for ambulance • Fall and the person is not able to get up or can be helped to get up

14. 24/7 Calls free from landline and mobile 111

15. Calling 111 • You need medical help fast but it's not a 999 emergency • You think you need to go to A&E or need another NHS urgent care service • You don't know who to call or you don't have a GP to call • You need health information or reassurance about what to do next

16. How does it work? • Trained advisors • Questions to assess your symptoms • Advice or direct to best health care service – A&E/ OOH service/ Community Nurse / Emergency Dentist • Book an appointment or transfer directly to the people you need to speak to

17. How does it work? • If 111 advisers think you need an ambulance they will immediately arrange for one to be sent • Calls are recorded

18. Out-of-hours services • From 6.30pm to 8.00am on weekdays and all day at weekends and on bank holidays • Best to call 111 • GP service available at the Pilgrim Hospital • Home visiting done by team of trained nurses

19. Old Leake? • We deal with anything that is not suitable for 999 or A&E and everything else • If you have something urgent between 8am to 630 pm call the surgery to see if we can help • Situations clearly suitable for 999/ A&E are best dealt with by them • The surgery provides home visits but makes it very difficult to provide these if requested after about 1 pm

20. Self Help • I am going to mention three emergencies and three common generally minor illnesses

21. Suspected Heart Attack • Pain in centre of chest like pressure, squeezing or tightness • May be sick and sweaty • Call 999 • Sit the person down • Reassure and watch closely • Give 300mg Aspirin to chew slowly unless reason not to use • If they have a GTN spray help them use it

22. Insanity?

23. Not to be Missed

24. Not to be Missed

25. Suspected Stroke • F- Facial weakness: is the person unable to smile evenly, or are their eyes or mouth droopy? • A - Arm weakness: is the person only able to raise one arm? • S - Speech problems: is the person unable to speak clearly or understand you? • T - Time to call 999 if a person has any of these symptoms

26. Fall or Fracture • If in any doubt treat the injury as a broken bone • Call 999 if the person has severe bleeding, or breathing difficulty or is unconscious • Keep the injury still • With a broken finger or arm may be able to drive them to A&E without causing more harm

27. What has happened?

28. Hip fracture • Unable to move, lift or turn leg • Unable to stand or put weight on your leg • Shorter leg, or your leg turning outwards more on the injured side • Call 999 • Try not to move while you are waiting for an ambulance • keep warm

29. Recognise this?

30. Colds • Average 2-4 colds per year • Will generally get better on its own within a week without any specific treatment • Drink enough fluids – use your thirst as a guide • Steam inhalations with menthol • Hot drinks (particularly with lemon) and lozenges

31. Colds • Can use Paracetamol and Ibuprofen • Aspirin is ok but not under 16 years • Decongestant tablets or nasal drops can help but should not be used for > 7 days • Cough medicines are used but little evidence for benefit • Antibiotics not needed • Echinacea or zinc may help prevent

32. What does this cause?

33. Diarrhoea • Usually improves within a few days – 2-4 days in adults and 5-7 days in children • Main risk is dehydration • Drink plenty – small frequent sips • Rehydration drinks may help • Don’t starve – small, light meals • Anti-diarrhoeal medications Imodium may help

34. Diarrhoea • Seek help – Blood or mucus in the stool High fever Continuous vomiting Not passing urine Diarrhoea continues more than 1 week

35. What is this test?

36. Fever in children • Temperature more than 37.5 ( 99.5) • Mostly caused by infections commonly colds, ear infections, throat infections, etc • If the child is otherwise well and playful it is less likely they have a serious illness

37. What can you do? • Encourage fluids • keep them cool - cover with a lightweight sheet and keep room around 18 degrees • Use children's Paracetamol or Ibuprofen – Do not give them both at the same time but if one doesn’t work you can try the other later

38. When to get help? • Vomiting > twice per day • Dehydrated • 0-3 months and temperature > 38 • > 3 months and temperature > 39 • Fit • Headache/ confusion/ drowsiness • Rash that does not fade on pressure • Fever lasts> 5 days • You are concerned

39. Summing it all up • If you think it is anything that is life threatening or cannot wait more than few minutes call 999 • Do not ignore signs of heart attack or stroke • A lot of conditions are self limiting and simple measures suffice • Trust your instincts with children – if you are worried get help