treatment of minor ailments and managing the emergency is one of the component of PHC and essential for community nurse, in this ppt points are included like principles, classification, general and systemic minor ailment and its management, standing orders, role of CHN.

1. MINOR AILMENTS AND
STANDING ORDERS
PRESENTED BY
Puja Sharma

2. INTRODUCTION
• Treatment of minor ailments and managing the emergencies is one of
the components of Primary health care.
• Minor ailments indicate slight illness, emergencies of smaller nature,
acute and chronic illness which need immediate care .
• Nurses should be capable to examine sign and symptoms of illnesses
and treat them in case of minor ailments.

3. PRINCIPLES OF MANAGEMENT
Ensure a safe & healthful environment for patients
Treat the risk /injured person promptly to prevent the complication
For infectious disease take appropriate measures to prevent the spread
Continuous observation & check vital sign
Help the client to perform her/his ADL
Provide health education
Remember the limitation in providing treatment
Help the family members in care of the client and in adjustment
Respect the belief of client
In case of doubt about diagnosis or serious condition refer the patient
without delay.

4. CLASSIFICATION
General Minor
Ailments
Systemic Minor
Ailment
Behaviour
problem

5. GENERAL MINOR AILMENTS
Injury and fall
Fractures
Burns
Dogbite
High fever
Heat stroke
Diarrhea
Fainting

6. SYSTEMIC MINOR AILMENTS
• EYE
• Eye accidents
• Foreign bodies
• Infection
• Poor eye sight
• Dry eyes
• Night blindness

7. Con…
EAR
• Earache
• Foreign bodies
• Otitis media
• discharge
• Temporary deafness

8. Cont…
RESPIRATORY TRACT
• Allergic rhinitis
• Common cold
• Sinusitis
• Sorethroat
• Cough
• Dyspnea
• Chest pain
• Asthmatic attack

9. Cont….
• CARDIOVASCULAR SYSTEM
• Hypertension
• Anemia
• Rheumatic heart disease

10. Cont….
• DIGESTIVE SYSTEM
• Toothache
• Stomatitis
• Soreness in mouth
• Constipation
• Diarrhea
• Indigestion
• Vomiting
• Abdominal distension
• Pain abdomen
• Intestinal obstruction
• haemorrhoid

11. Cont…
URINARY SYSTEM
• Burning micturition
• Haematuria
• Retention of urine
• Urinary infection
• Renal stones

12. Cont….
NEUROMUSCULAR SYSTEM
• Headache
• Backache
• Convulsion
• Epileptic fits

13. Cont….
REPRODUCTIVE SYSTEM
• Dysmenorrhea
• Heavy bleeding
• Sores
• Discharge from genital
• Breast lump

14. Cont…
BEHAVIOUR PROBLEM
• Maladjustment
• Emotional disturbances

15. GENERAL STEPS FOR MANAGEMENT OF MINOR AILMENTS
If condition does not improve or serious sign appear refer the client
If outcome is successful, plan & followup
Evaluate care and patient condition
Provide treatment & nursing care
Find the cause, making diagnosis & planning
Assessment – taking history, physical examination

16. STANDING ORDER
• Standing order are the direction and order of specific nature
• In the nonavailability of doctors , the nurses and health workers can
provide treatment to patient at home , hospital, or health institution
in written form .
• This should be followed on temporary basis or in case of emergency
or absence of doctor.

17. OBJECTIVE
To maintain the continuity of the treatment of the patient
To protect the life of patient / to resuscitate him
To create the feeling of responsibility in the members of health team.

18. USES
Providing treatment during emergency
Enhance the quality and activity of health services
Strengthening of primary health services in the community
Decentralization of health responsibilities
Developing the feeling of confidence and responsibility in nursing and other
health worker
Protecting the general public from quacks
Enhancing the faith of general public in medical institution / community health
services

19. TYPES OF STANDING ORDER
INSTITUTIONAL OR
INSTRUCTIONS S.O
• This S.O prepared with
available resources, staff
position, & objectives of
medical institution
• Eg. S.O differ from PHC than
in District hospital
• Government and private
clinic
SPECIFIC S.O
• Prepared for the trained
medical personnel, mainly
for nurses .
• This require technical
knowledge & special skills
• Eg. Giving injection, oxygen
GENERAL S.O
• Due to large population &
geographical area and
shortage of health resources
• Common man are expected
to follow these
• Eg. ORS in case of
dehydration, PCM for fever

20. MANAGEMENT OF MINOR AILMENT AS PER STANDING
ORDER

21. FEVER
• MEANING
• It is an abnormal rise of the temperature
of the body above than 37*C ( 98.6*F)
• Fever indicates some abnormalities in the
body function and shows presence of
infection or disease, disorder.
• PRIMARY INTERVENTION
 Assess the vital signs
 History collection including cause, any other symptoms
like vomiting , shivering, cold allergy, cough etc.
 Provide rest and light meal.
 Prepare for blood slide to examine malaria parasite
 Give PCM
 Give more oral fluid
 Provide cold sponging if fever is >39*C(102.2*F)
 Monitor the patient and wait for two days
 If fever accompanied with rashes then keep in isolation
or if necessary inform doctor
 In case of delirium, convulsion, unconsciousness,
hyperpyrexia with fever ,refer the client

22. HEAT STROKE
MEANING
• Heat stroke is a severe heat illness ,
defined as hyperthermia with a body
temperature > 40*C( 104*F) due to
environmental health exposure
• It is also known as sunstroke
PRIMARY INTERVENTION
Keep the client in shade and well
ventilated place
Monitor vital signs and record
Remove the clothes
Wrap him/her in a wet sheet till the
temperature falls 38*c
If the client is conscious give him cold
water mixed salt and other cold drinks
Continuously observe the temperature
As soon as there is improvement in the
condition of client refer him to the hospital

23. DIARRHOEA
MEANING
• Diarrhoea is defined as the passage of three
or more loose motion or liquid stool per day (
or more frequent than normal)
• This is the leading cause of malnutrition in
children under five years of age and it is the
main cause of death .
• Usually it is a symptoms of an infection in the
intestinal tract
PRIMARY INTERVENTION
History collection
Monitor the symptoms of dehydration
If dehydration is severe and shock is present
immediately refer the client to hospital
Provide ORS
Give rice water, coconut water, lemon juice,
banana, light tea, khichadi etc.
If there is epidemic of vomiting and diarrhea,
take sample and send for stool test
If cholera is prevalent take appropriate action
like protect food & water and inform physician
Give Health education to control the flies ,
proper disposal and food hygiene
Give medication as per need

24. BURN
MEANING
• A burn is the injury to the skin or other organ
tissue primarily caused by heat or due to
radiation, radioactivity, electricity, friction, and
contact with chemical
• Thermal burn occur when some or all of the cell in
the skin of tissue is destroyed by
Hot liquid( scald)
Hot solid ( contact burn)
Flames ( flame burn)
PRIMARY INTERVENTION
• Check the spreading of burn &Stop the burning
process
• Keep the burnt part of body immersed in water
• If the clothes has stuck on the burned part do not
try to remove , though rings, bangles, shoes belts,
and other tight fitted articles should be removed
• Do not touch the blister unnecessary
• Cover the burnt part with a clean clothes
• Assess the condition of client and percentage of
burn
• If client is conscious and no vomiting give ORT
• If is in shock give primary treatment
• Provide analgesics if required
• Refer the client for further care

25. DROWING
MEANING
• It is a process of experiencing
respiratory impairment from
submersion/ immersion in liquid.
• Males & children are at high risk
• Acc. To WHO it is a 3rd leading cause
of unintentional injury death
worldwide
PRIMARY INTERVENTION
• Loosen the clothes from chest
• Make the patient lie on his abdomen
and get the water out of his lung
• Resuscitate the patient
• Immediately send him to the health
center/hospital

26. ANIMAL BITE
MEANING
• Rabies is a significant health
concern following dog bite, cat
bite, monkeys bite
• Every year 5 million are bitten by
snakes
PRIMARY INTERVENTION
•Monkey bite
Wound dressing
Inj. TT( if not adequately
vaccinated)
Antibiotics
Anti rabies treatment

27. DOG BITE
PRIMARY INTERVENTION
 Wash the wound thoroughly with soap and water . Use running water
 Apply betadine or tincture iodine, if available ARS can be used for
dressing but serum sensitivity test is essential before use
 If wound is extensive Check for hemorrhage but stitches should be done
after 24 hrs.
 Give inj. TT
 Do not kill the dog observe for 10 days
 Send patient to hospital for ARV therapy

28. CAT BITE
PRIMARY INTERVENTION
 Wound dressing
 Administer TT vaccine ( if not vaccinated)
 Antibiotics
 ART

29. SNAKE BITE
PRIMARY INTERVENTION
 Discourage the traditional first aid ( they do more harm than good)
 Reassure the client
 Movement or contraction increases the absorption of venom into blood and
lymphatic.
 Immobilize the whole body by lying down in comfortable position
 Immobilize the bitten limb with splint and sling,use bandage or clothes to
hold the splints.
 NEVER USE TOURNIQUATE to block the blood supply
 Don’t offer alchoholic beverages or stimulants( these are vasodialators)
 Remove ring, watch , bracelet , footwear, from bitten part
 Incision or applying ice on bitten site is not recommended
 Transfer the client

30. SCORPION BITE
PRIMARY INTERVENTION
 Remove the sting, if possible and apply
pressure dressing
 Reassure the client
 For mild pain use ice packs
 For severe pain, inj. Lidnocain (without
adrenaline) along with oral diazepam
and any NSAIDs
 Observe client for at least 24hrs

31. FAINTING
MEANING
• Fainting( syncope) is a sudden loss
of consciousness that usually result
in fall.
• Causes –
 Reduce blood flow and oxygen to
the brain
 Pain
 Emotional stress
 Prolonged standing, laughing,
weeping
PRIMARY INTERVENTION
Lie down the person. Head should
be at a slightly lower level than the
feet
If person is sitting –keep his head
bended between both legs
Remove the crowd
Once the person gets his
consciousness ask him to take deep
breath and offer liquids to drink
If unconsciousness continues send
immediately for treatment

32. INJURIES AND FRACTURE
MEANING
• Fracture is the complete or
partial break in bone
PRIMARY INTERVENTION
• Clean the wound with soap & water
• Apply spirit around the wound
• Apply betadine lotion & bandage the
wound
• Monitor the condition of client with
fractured bones
• Treat the patient for shock
• Immobilize the fractured part of the
patient body using splint
• Give analgesics and inj. TT
• Send him to hospital

33. WOUND
MEANING
• Wound is an injury to living
tissue caused by a cut blow, or
other impact , typically one in
which the skin is cut or broken
PRIMARY INTERVENSION
• Wash the wound with clean boiled
water and antiseptic lotion
• Apply spirit around the wound
• Remove all foreign bodies present in
the wound like glass, peace of wood,
stones or dirt etc.
• Bandage the wound using betadine.
• Give the injection TT.
• Check the bleeding from wound.
• If suture is needed send the patient to
hospital

34. STANDING ORDER FOR MCH CARE
MEANING
• Maternal & child health care is
the health service provided to
the mothers and the children.
PRIMARY INTERVENTION
• GIVE TABLETS in case of vomiting and nausea.
• toxemia of pregnancy advised to take restricted salt
diet and complete rest if there is edema refer the
client.
• Send the mother to the hospital in case of APH or
PPH.
• If the mother develops fever after delivery try to
know the cost and give anti pyretic and refer to
client.
• Provide comfort to the mother in case of excess of
milk in the breast , stillbirth and refer the client etc.
• Observe the abnormality and deformaties and refer
the client.
• Provide warmth
• Initiate breast feeding as early as possible.

35. CONVULSION IN CHILDREN
MEANING
• Convulsion is a sudden
uncontrollable muscle
contraction or violent
movement of the body .
PRIMARY INTERVENSION
• LIE down The child safely on A Bed.
• Loosen his cloths from its chest
• Turn the head one side
• Clean the secretion from its mouth.
• In case of fever give him cold
sponge
• Try to know cause an refer to
client.

36. Hemorrhage
MEANING
• It is the release of blood from
the broken vessels
• Blood loss inside the body called
internal hemorrhage & blood
loss outside the body is called
external hemorrhage
Primary intervention
• Lie down the person straight on his back
• Take the BP and vital signs.
• Press a pad on the point of bleeding. Till
bleeding stop
• Bandage once bleeding under control
• Give him liquids
• Try to find out causes of bleeding
• Monitor the state of stroke
• If it is out of control send the person refer
the client

37. UNCONSCIOUSNESS
MEANING
• It is a state which occur when
the ability to maintain an
awareness of self and
environment is lost
PRIMARY INTERVENSION
• Lie the person in such a position his
respiratory system works properly.
• Lie down the person in a well
ventilated place
• Remove the dentures
• Clean the secretion from the mouth
• Loosen the cloth from his neck , chest
and vest.
• Provide artificial respiration in case of
blocked breathing
• Find out the cause refer the client.

38. ROLE OF COMMUNITY HEALTH NURSE
HISTORY COLLECTION
• History of general health of the patient
• History of onset of disease
• Its intensity and symptoms of disease
• Family illness
• Pre medical history

39. • Find out the action taken
• Complication and any specification
• Check vital sign and record
• Conduct urine test
• Identify problem
• Provide nursing service
• Consoling the individual and family
• Implement referral system
• Regular study and monitoring of standing order manual/ health book
• Inform health officer immediately.
• Notify communicable disease
• Keep medicine kit ready .
• In case of doubt about the standing order collecting complete information
• Careful about once limit and maintain faith
• Ensure a safe and healthful environment.