“Before You Call the Doctor,” Tambuli, June 1980, 18

Before You Call the Doctor

By Suzanne Dandoy

Before contacting a doctor when a family member is ill, you should closely observe the sick person. If the situation is not an emergency, make written notes of your findings. It is too easy to overlook an important sign if you rush to call the doctor without first completely evaluating the illness. Symptoms are those complaints that the ill person relates himself, such as pain, stiffness, shortness of breath, or loss of energy. Signs of illness are those objective findings that an observer can detect, such as elevated temperature, bleeding, or rash.

In order to report signs and symptoms in an organized manner the following checklist can be used:

Pain

[ ] Location
[ ] Type (dull ache, stabbing, shooting)
[ ] Duration (continuous or intermittent)
[ ] Is it affected by change in body position?
[ ] Is it affected by eating?

Temperature

[ ] Report actual reading from thermometer

Pulse

[ ] Report number of pulse beats per minute
[ ] Report number of breaths per minute
[ ] Does breathing appear difficult?
[ ] Is he coughing?

Bleeding

[ ] Location
[ ] Color (bright red, watery)
[ ] Amount (steady flow, intermittent, oozing)

Body Discharges

[ ] Changes in color or character of stools, vomitus, sputum, urine, or other discharges. (If discharge is unusual in appearance, save a sample in a covered container for the doctor to examine.)

Skin

[ ] General appearance: red, sweating, pale, yellow
[ ] Is there local reddening or discoloration in any area?
[ ] Rash (give location and description)

General

[ ] Does the patient look sick?
[ ] How does he say he feels (loss of energy, tired)?
[ ] How long has he been sick?
[ ] Is there loss of appetite?

In addition to a description of signs and symptoms, the doctor will want to know what first-aid or treatment has been given to relieve the patient’s symptoms and any medication that the patient has been taking.

By providing the physician with a complete report of the patient’s condition, you will greatly assist him in making an accurate diagnosis and in starting early treatment of the ill person.

What Is Fever?

Fever is a sign that something is wrong in the body, although sometimes a person may be ill without an elevation of temperature. A change from the normal body temperature has been used by doctors for years as a basis for judging whether a person is sick, for diagnosing and treating illness, and for noting the progress of the patient’s recovery from illness. One of the first questions asked when illness occurs will frequently be, “What is the temperature?” It is therefore desirable for every family to own a clinical thermometer and to know how to use and care for it.

Temperature should be taken under the following conditions:

1. Whenever a person complains of feeling ill or shows signs of illness.

2. During illness, once or twice a day, at the same time each day, usually once in the morning and once in the evening, or whenever the doctor orders. (Temperatures may be taken as often as every four hours or only once a week, depending on the condition and age of the patient.)

3. Whenever there is a sudden change in the patient’s condition, such as a chill, restlessness, or pain.

4. Whenever there is headache, pain in the chest or the abdomen, sore throat, chills, vomiting, diarrhea, or skin rash.

The patient should not be awakened to have his temperature taken. For accuracy, there must be a wait of at least 15 minutes between the time a temperature is taken and the time the patient has had a hot or a cold bath or had taken hot or cold food or drink, because temperature in the mouth under these conditions will not be the same as the actual body temperature. With older children, the best time to take a temperature is when they are relatively calm or rested.

Besides knowing how to take a temperature and read a thermometer, you should have some knowledge of how to interpret what you read. In adults, a reading of 100 degrees Fahrenheit (37.8 degrees Centigrade) would be considered a significant indication of fever. With infants, 101 degrees Fahrenheit (38.3 degrees Centigrade) would be considered a significant fever. Everyone has variations in temperature during a 24-hour period, and it is normal for the temperature to go up slightly in the late afternoon and to be lowest in the early morning hours.

Remember that fever itself is not an illness. It is a sign of illness. But it doesn’t have to be the only sign. Someone can be extremely sick without having a fever at all. The absence of fever, when other symptoms of fever are present also should be reported to your doctor.

Don’t panic if your child has a temperature peak of 103 or 104 degrees Fahrenheit 39.4 to 40.0 degrees Centigrade). The height of the temperature isn’t always a measure of how sick a child is. However, a fever in infants under three months old is unusual. It has more significance than the same temperature in older children—and should always be diagnosed by your doctor.

Sometimes a doctor will ignore the fever and concentrate on curing the illness itself. This is because the fever is one of the ways the body fights the illness. It is also a means the doctor can use to measure the course of the illness. But if a high fever is interfering with the sick person’s sleep—or exhausting him—the doctor will probably try to lower it.

Home Nurse Pharmacy

Although we generally consider as medicines only those items that have been ordered by a physician’s prescription, other substances that are found in many homes can also be considered as medicines. These medicines should be available at any time so that the home nurse can respond immediately to the needs of an ill or injured family member. Often someone will need relief of symptoms at night or at other times when it is not convenient to go to the pharmacy.

A home nurse with the following items available will be better equipped to care for ill members of the family:

[ ] Aspirin, including children’s aspirin*
[ ] Nasal decongestant (drops or spray)*
[ ] Cough medicine*
[ ] Sore throat lozenges
[ ] Antibiotic ointment for infected skin areas*
[ ] Petroleum jelly
[ ] Calamine lotion
[ ] Burn ointment or analgesic spray
[ ] Antihistamine tablets or capsules*
[ ] Sunburn protective cream or lotion

As with prescription medicines, all these items should be discarded when they become discolored or when there is any change in appearance or smell. All medicines should be kept in a locked cabinet if there are children in the family; parents should also attach a label indicating the appropriate antidote on bottles containing poison.

In addition to medications, the family should have a supply of other items that are often needed on an immediate basis:

[ ] Thermometers (oral and rectal)
[ ] Medicinal alcohol (70%)
[ ] Antibacterial soap (to cleanse cuts and abrasions)
[ ] Absorbent cotton and cotton wound around one end of a small stick (used for applying medication or removing material from an area)
[ ] Adhesive bandages
[ ] Adhesive tape (1 1/4 cm. or 2 1/2 cm. wide)
[ ] Sterile gauze pads in assorted sizes
[ ] Scissors
[ ] Tweezers
[ ] Tongue blades
[ ] Small first-aid book

These items should be kept together in a convenient location known to all members of the family. A family can handle illness or injury in a calm, unhurried manner if the proper supplies and medicines are readily available. Of course, if the problem is serious, a physician should be consulted.