SAS Urban Survival Handbook (119 page)

If the ‘victim’ is a stranger, it may be difficult to deduce what is wrong with them. If they are conscious, ask them if they know what is wrong. They, too, may have a ‘permanent’ illness or condition—they may even carry a card or wear a bracelet to let everyone know they have a serious health problem or are on regular medication. If the ‘victim’ is unconscious, search them quickly for any evidence to suggest that they have a particular problem of this sort.

Unsteadiness, irrational or abusive behaviour, or collapse may suggest a person is drunk. It can also result from a serious emergency, such as may occur in someone who is diabetic. If someone collapses, obviously from alcohol, place them in the recovery position (to keep the airway open). Don’t forget that anyone who is unconscious is at risk and that alcohol can lead to severe poisoning and death.

The intention in this section is to help you know when to call for help. If in any doubt—especially if someone is obviously very ill—don’t waste time thumbing through a book. Pick up the telephone instead!

Seek medical attention
indicates that the sick person should be seen by a doctor. You’ll have to decide whether to take them to the doctor, to call the doctor to visit or to drive them to the casualty department of a hospital.

Seek urgent medical attention
indicates that the condition may be more serious or even very serious. Don’t waste a single moment!

CALL AN AMBULANCE
means just what it says. Do so, and then monitor the ‘patient’s’ condition or apply first aid (see
Save a life!
) until the ambulance arrives.

CHILDHOOD DISEASES

As soon as a child starts mixing with other children, at playgroup, nursery or school, he/ she inevitably comes into contact with all the common childhood infections. For two or three years there will be not only colds, tonsillitis, ear infections and so on, but the risk of catching the well-known ‘infectious diseases’.

Many of these can be prevented if the child has been immunized against them. Parents should make sure to take their child to the clinic or doctor at the correct ages, and that they keep a record of all the routine immunizations. Some of the diseases—for example, whooping cough in babies and young children, polio at any age—can be very dangerous.

Immunization, whether by injection or by swallowing a drop of the vaccine on a lump of sugar (polio immunization) usually has few after-effects. However, some may cause slight pain and swelling at the site of the injection, followed by mild fever (something like flu) and irritability. Painkillers such as paracetamol (NEVER give aspirin to a child under twelve) can help. Sometimes, as in the case of measles, there may be mild symptoms of the disease, which will pass quickly.

Some parents have been worried about the whooping cough vaccine because in a tiny minority of cases there has been brain damage following this immunization. If you are concerned about this, talk to your doctor. Medical opinion favours immunization because whooping cough in very young children can be a VERY serious disease, with much greater risks than those posed by the innoculation.

IMMUNIZATION SCHEDULE

AT 2, 3 AND 4 MONTHS

■
DPT (one injection)

For diphtheria, whooping cough, tetanus

■
Polio (by mouth)

AT 12-18 MONTHS

Usually before 15 months

■
MMR (one injection)

For mumps, measles and German measles

AT 5 YEARS

About the time of starting school

■
Diphtheria/tetanus (one injection)

■
Polio (by mouth)

CHICKEN POX

Common infectious childhood disease. Not usually serious, but rare cases involve complications. Once you’ve had chicken pox, you are immune. The virus is spread in airborne droplets. Infectious from about two days before a rash appears, to approximately one week after. The same virus
Herpes zoster
can cause shingles in later life.

SYMPTOMS
Two to three weeks after contact, a rash appears behind the ears, in the mouth, armpits, on the trunk, upper arms and legs. There may also be a dry cough. Within a day or two, rash resembles clusters of itchy red spots, which turn into fluid-filled blisters. These soon dry out to become scabs. There may be a raised temperature.

WARNING In rare cases there may be complications, with coughing, vomiting and a high fever. If this occurs, or if the spots become inflamed, if the eyes are affected or a severe headache starts, seek urgent medical attention.

ACTION
Seek medical attention—a home visit is advisable. Treatment includes low doses of paracetamol to reduce fever and calamine lotion to relieve itching. The child’s nails should be kept short. Scratching of the blisters and scabs should be discouraged, to prevent infection and scarring.

WARNING Adults who have never had chicken pox should stay away from anyone who has got it (or away from any adults with shingles). Women in the final stages of pregnancy should be especially careful—newborn babies can develop severe/dangerous attacks of the disease. Anyone who is being treated for leukaemia or is HIV positive could be at great risk.

SHINGLES
An adult person, who has had chicken pox, may contract shingles.

SYMPTOMS
Pain in the area of skin affected, then, about five days later, a rash. This starts as small, raised, red spots that soon become blisters. After three days the blisters turn yellow, then dry and crust over. Within a couple of weeks the crusts fall off, often leaving small scars.

ACTION
The sooner medical treatment with anti-viral drugs is given, the better the chances are of reducing the severity of the disease and nerve damage.

WARNING Once the disease has passed its earliest stages, little can be done to relieve post-herpetic pain. On the face, shingles is usually confined to the eyelids and forehead, but can be extremely serious if the eyes are affected.

MEASLES

Viral illness which may be serious. Usually affects children, but can also occur in adults. In most cases, once you’ve had measles, you’re immune.

SYMPTOMS
Fever, rash, runny nose, sore eyes and a cough. In four days, rash develops on the head and neck and spreads to the whole body. Lymph glands may become enlarged. Symptoms start to disappear after three days.

ACTION
Seek medical attention—a home visit is advisable. In rare cases complications develop. Give low doses of paracetamol (NOT aspirin) and plenty of drinks. Antibiotic drugs

will take care of any minor, bacterial infections if these occur.

PREVENTION
Important, because of possible complications. The MMR vaccine is now routine. See
Immunization schedule.

WARNING Those with impaired immune systems, such as anyone with leukaemia or who is HIV positive, should keep away from children with measles. This also applies to pregnant women—20 per cent of pregnant women with measles miscarry—though there is no evidence that the illness causes any birth defects.

MUMPS

Serious viral illness. Usually affects children, but may also occur in adults. Once you’ve had mumps, you are immune. 25 per cent of boys/ men who contract mumps (after puberty) experience inflammation of the testes (orchitis). If this occurs, one testis may be swollen and painful for a few days and may shrink slightly when the illness passes. If both testes are affected, there is a slight chance of subsequent infertility. Women may develop inflammation of the ovaries. In either sex, inflammation of the pancreas can cause abdominal pain.

SYMPTOMS
Usually develop gradually. A raised temperature, difficulty swallowing and pain behind the ears, leading to swelling of glands beneath the jaw bone on one or both sides of throat. Swelling usually disappears after seven days.

ACTION
Most cases last a few days only. A doctor will make sure there are no complications. Give low doses of paracetamol (NOT aspirin, for children under twelve) and plenty of fluids. Patient should rest in bed until symptoms have gone. If chewing is painful, soup is a good idea. The main priority in severe cases of orchitis is to reduce the pain and inflammation.

PREVENTION
MMR vaccine is part of the routine immunization schedule. Boys (after puberty) and men should avoid infection if they have not had mumps or been immunized against the illness. If symptoms of mumps do start to develop, an immunoglobin injection may offer a degree of protection against orchitis.

POLIO

Infectious viral disease, which mainly (but not exclusively) affects children. Three closelyrelated polio viruses have been identified. Infected people pass the virus in their faeces. Scrupulous hygiene is VITAL.

SYMPTOMS
Sore throat, mild fever, headache, vomiting and muscle ache are early signs of the minor form of polio and last for two or three days. Only about 15 per cent of those infected go on to develop the major form of polio, in which the early symptoms are followed by chronic headache, high fever, intolerance of light, a stiff back and neck, muscle pains and perhaps twitching, all caused by inflammation of the membranes covering the brain and spinal cord (meninges). In rare cases, paralysis of some muscles occurs. This may lead to breathing difficulty and may even cause death.

ACTION
Seek urgent medical attention or call an ambulance. Although the majority of those who suffer the most serious kind of polio make

a full recovery, cases where paralysis sets in can be fatal and MUST be treated straight away. Hospitalization is VITAL, in case artificial respiration may be needed. There is no effective drug treatment, but physiotherapy can aid recovery.

REMEMBER
Polio can be prevented by immunization at specified ages during childhood. As a result of routine immunization, polio is very rare in industrialized countries, but still a risk in the Third World.

GERMAN MEASLES

Also called rubella. Common viral illness in children. Only a few similarities to measles. It is of importance as a severe risk to women in the early stages of pregnancy. Once you have had rubella, you are immune.

SYMPTOMS
A rash of pink, slightly raised spots on the face, behind the ears and on the trunk and limbs for a few days. Glands, especially near the back of the neck, may become swollen. There is often a fever and swollen—sometimes painful—joints.
ACTION
Paracetamol should reduce the fever, and fluids may be given to drink. If there is pain from the joints or glands, or the patient’s temperature rises, call a doctor.

WARNING A pregnant woman should avoid ALL contact with anyone who has rubella. If she is exposed to the virus there could be severe consequences for the foetus. Women who have not had rubella, and wish to have children, should be immunized against the virus. Pregnancy should not be considered until at least two months after the immunization.

SCARLET FEVER

Infectious disease, caused by an airborne bacteria. It is transmitted when the patient coughs. These days it is no longer a dangerous disease in the UK.

SYMPTOMS
Sore throat, fever, headache and a rash, which begins as tiny red spots on the neck and upper body and soon spreads over the face. White coating and red spots cover the tongue. A few days later the tongue is bright red. As the fever and rash start to subside, the skin on the hands and feet may be flaky or peeling.

ACTION
Seek urgent medical attention. Antibiotic drugs, such as penicillin, may be prescribed. Ensure plenty of rest and fluids. Paracetamol will ease the fever.

WHOOPING COUGH

Caused by an airborne bacterium, whooping cough (pertussis) can be fatal. Spread when the sufferer coughs. Usually affects small children and babies. Most infectious before the ‘whoop’ of the cough has begun.

SYMPTOMS
Sneezing, mild cough, runny nose and sore eyes. Soon develops into bouts of coughing, usually with the characteristic ‘whoop’ sound. Symptoms may last for up to ten weeks, if not treated immediately.

ACTION
Seek urgent medical attention, especially if a child vomits after coughing or appears to turn blue. Keep the patient warm. Give plenty of fluids and small regular meals. Avoid exposure to cigarette smoke and draughts.

PREVENTION
Prevention is important, because of possible complications. These include dehydration and pneumonia, which are life-threatening to very young children and babies, especially if premature. Infants should be immunized.