Table of Contents. Section One - Wise Medical Consumerism. Section Three - Emergency / First Aid. Section Two - Common Health Problems

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1 Table of Contents Section One - Wise Medical Consumerism You & Your Health Choosing a Health...4 Your Primary Doctor Before You a Specialist 5 Tell & Ask the Doctor / Checklists...5 Medical Exams & Tests Having a Routine Checkup...7 Tests & What They Are For...7 Health Tests & When to Have Them...8 Immunization Schedule...9 Medications Safe Use of Medications...10 Questions to Ask About Medications...11 Over-the-Counter (OTC) Medications...11 Your Home Pharmacy...12 Overhauling Your Medicine Cabinet...13 Medical Decisions Types of Complimentary and Alternative Medicine...14 Safe Use of Alternative Medicine Products and Services...15 Making Medical Decisions...16 Informed Consent...17 Advance Directives...17 Section Two - Common Health Problems How to Use This Section...18 Health Problems Abdominal Pain...19 Acne...22 Anxiety...24 Asthma...28 Back Pain...30 Bronchitis...34 Chest Pain...36 Common Cold...38 Constipation...40 Coughs...41 Depression...43 Diarrhea...45 Earaches...47 Fatigue...50 Fever...52 Flu & SARS - Severe Acute Respiratory Syndrome...54 Hay Fever...56 Headaches...58 Heartburn...62 Ingrown Toenails...64 Laryngitis...65 Shoulder Pain & Neck Pain...66 Sinus Problems...70 Skin Cancer...72 Skin Injuries...74 Skin Rashes...77 Sore Throats...84 Sprains, Strains, & Sports Injuries...85 Urinary Tract Infections (UTIs)...88 Vomiting & Nausea...90 Section Three - Emergency / First Aid What is a Medical Emergency...92 First Aid Safety Steps...92 Emergency Procedures...93 I. Cardiopulmonary Resuscitation (CPR)...93 II. First Aid for Choking...95 III. First Aid for Poisoning

2 Earaches Signs & Symptoms Mild to severe ear pain Feeling of fullness or discomfort in the ears Tugging at the ear and restlessness in young children Outer Ear Canal Causes The most common cause of earaches is plugged Eustachian tubes, which go from the back of the throat to the middle ear. With a blocked Eustachian tube, fluid or pressure is present, causing pain. Causes for this are middle ear and sinus infections, colds, and allergies. Other causes of ear pain are changes in air pressure in a plane, something stuck in the ear, too much earwax, tooth problems, and ear injuries. Questions to Ask Did the ear pain start after a blow to the ear or recent head trauma? Flowchart continued in next column Inner Ear Eardrum Eustachian Tube Diagram of Ear Middle Ear With the earache, do any of these symptoms of meningitis occur? Severe, persistent headache Stiff neck (can t touch the chin to the chest) Lethargy Seizure Red or purple rash that doesn t fade when pressed With ear pain, are any of the following signs present? Vomiting Fever (see pages 52 and 53) Sticky, green, or bloody discharge The ear pain is severe and/or increases when wiggling the ear lobe. With an earache, does a child not respond to a whistle or a loud clap? Does a child show the following signs, especially after a respiratory tract infection, a cold, air travel, or if the child has had ear problems before? Constant pulling, touching, or tugging at the ear(s) Fever Crying that won t stop Ear or ears that are hot and hurt when touched Acting cranky and restless, especially at night or when lying down Flowchart continued on next page 47

3 Common Health Problems Earaches Treatment Severe and/or constant ear pain needs medical treatment. This may include pain relievers, an antibiotic for a bacterial infection, and methods to dry up or clear the blocked ear canal. Self-care can treat mild ear pain with no other symptoms. Prevention Heed the old saying, Never put anything smaller than your elbow into your ear. Doing so could damage your eardrum. When you blow Don t put cotton-tipped swabs, bobby pins, your fingers, etc. in your ears. your nose, do so gently, one nostril at a time. Don t smoke. Smoking and secondhand smoke can increase the risk of blocking the Eustachian tubes. Does a more than mild earache persist and occur after any of the following? A mild ear injury Blowing your nose hard or many times A small object has been stuck in the ear that cannot easily be removed or an insect has gotten in the ear that cannot safely be removed. A cold, sinus, or upper respiratory infection Exposure to extremely loud noises (e.g., rock concerts, machines, etc.) With the earache do you also have hearing loss, ringing in the ears, dizziness, or nausea? Does the earache last longer than 2 weeks? Does the earache occur with jaw pain, headache, and a clicking sound when opening and closing the mouth? To Reduce Pain Self- Place a warm washcloth or heating pad (set on low, adults only) next to the ear. Some health professionals recommend putting an ice pack over the painful ear for 20 minutes. Take an over-the-counter pain reliever. Use Self- An over-the-counter pain reliever can help reduce ear pain. 48

4 Common Health Problems Earaches To Open Up and Help Eustachian Tubes Drain Sit up. Prop your head up when you sleep. Yawn. Chew gum or suck on hard candy. (Do not give to children under age 5.) This can help during pressure changes that take place during air travel. It can also help during the middle of the night if you wake up with ear pain. Take a steamy shower. When traveling by air, stay awake when the plane takes off and lands. Wear earplugs. Take a decongestant, such as Sudafed, which can relieve the swelling that causes the pain. (Don t use a nasal spray decongestant for more than 3 days unless advised by your doctor or health care provider.) Take a decongestant: At the first sign of a cold if you have gotten ear infections often after previous colds One hour before you land when you travel by air if you have a cold or know your sinuses are going to block up Use a cool-mist vaporizer, especially at night. Drink plenty of cool water. Yawning helps move the muscles that open the Eustachian tubes. Gently, but firmly, blow through your nose while holding both nostrils closed until you hear a pop. This helps promote ear drainage. It can be done several times a day. When you give a baby a bottle, have the baby in an upright position, not lying down. To Treat a Mild Case of Swimmer s Ear The goal is to clean and dry the outer ear canal without doing further damage to the top layer of skin. Shake your head to expel trapped water. Dry the ear canal. Get a clean facial tissue. Twist each corner into a tip and gently place each tip into the ear canal for 10 seconds. Repeat with the other ear, using a new tissue. Use an over-the-counter product, such as Swim- Ear as directed. Do not remove earwax. This coats the ear canal and protects it from moisture. To Avoid Getting Swimmer s Ear Wear wax or silicone earplugs. Wear a bathing cap to help keep water from getting into the ears. Don t swim in dirty water. Swim on the surface of the water instead of underneath the water. Use an over-the-counter product, such as Swim- Ear as directed. For an Insect in the Ear Shine a flashlight into the ear. Doing this may cause the insect to come out. For More Information, Contact: National Institute on Deafness and Other Communication Disorders (NIDCD)

5 Fever Fever is one way the body fights an infection or illness. It helps speed up the body s defense actions by increasing blood flow. Normal body temperature ranges from 97 F to 100 F. Signs & Symptoms Temperature higher than 100 F by mouth or ear; higher than 101 F by rectum The skin feels warm. Sweat. Use a digital or ear thermometer to measure body temperature. Don t use a glass mercury thermometer. If it breaks, droplets of toxic mercury can be released. the health department and your doctor if this happens. Temperatures are more accurate when they are tested inside the body, such as by mouth or rectum. 52 Causes Fever is usually a sign of another problem, such as an infection. Body temperature changes throughout the day. It is usually lowest in the morning and highest in the late afternoon and evening. Other factors that can affect your temperature reading include: Wearing too much clothing, if you re overdressed enough to raise your body temperature Exercise Hot, humid weather Taking your temperature by mouth after you drink a hot liquid like tea can also raise your temperature. Treatment If having a fever causes you no harm or discomfort and you have no other medical problems, you may not need to treat the fever. If the fever makes you uncomfortable, is 104 F or higher, or if you are frail or have a medical condition, you should treat it. Treatment includes self-care and treating the cause (e.g., taking an antibiotic for a bacterial infection). Questions to Ask Does an infant or child up to 3 years old have any of these problems? Temperature of F or higher in a baby less than 3 months old Temperature of 104 F or higher in a child between 3 months and 3 years old A fever along with inconsolable crying Flowchart continued on next page Don t use a glass mercury thermometer like the one shown here.

6 Common Health Problems Fever With a fever, do any of these signs occur? Seizure Shortness of breath or difficulty breathing Stiff neck, severe persistent headache, lethargy, or paralysis Excessive irritability Confusion, mental status changes Very severe abdominal pain With a fever, do any of these signs occur? Redness, swelling, and pain anywhere on the body Persistent ear pain or pain in the sinuses (face) Pain in the chest with deep breaths Sore throat Green, yellow, or bloody-colored discharge from the nose, ears, or throat or a cough with colored phlegm Urinary pain, burning, or frequency Vaginal pain, discharge, or bleeding (other than with normal menstruation) Has the fever lasted longer than 3 days without improvement? Are any of the following present? Temperature between 99.5 F and F in an infant less than 3 months old Temperature higher than F in a child 3 months to 3 years old Temperature over 104 F in a person between 3 years old and 64 years old Temperature of 102 F or higher in a person age 65 or older or in a person whose immune system is depressed Flowchart continued in next column Has the person with the fever recently been in the hospital or had a surgical procedure? Or, does the person have a chronic illness, such as asthma, heart disease, lung disease, kidney disease, cancer, or diabetes? Has the fever done any of the following? It went away for more than 24 hours and then came back. It occurred soon after a visit to a foreign country. It occurred after a DTaP or MMR vaccine and is present with dizziness. Use Self- Drink plenty of fluids, such as fruit juice, water, etc. Take a sponge bath with warm (about 70 F) water. Don t use cold or cool water. Don t use rubbing alcohol. Take the appropriate dose of an over-thecounter medicine to reduce fever. Rest. Don t do heavy exercise. Self- Don t wear too many clothes or use too many blankets. Rest when you have a fever. 53