This document provides standing orders and treatment guidelines for common minor ailments like fever, heat stroke, diarrhea, burns, drowning, bites, scorpion bites, and fainting that a community health nurse may encounter. The orders outline steps to examine patients, determine symptoms and severity, provide initial first aid like rest, fluids and medication, monitor vital signs, and refer more severe cases to a hospital or doctor as needed.

1. STANDING ORDER FOR TREATMENT OF
MINOR AILMENTS
• While working in health sub-center, primary health center,
community health center, hospital or institute, or home or
community, many times the community health nurse of other nurses
face the situation when it is necessary to provide treatment to the
patients
• e.g. at that time or place where no doctor is available or is likely to
come late. In such conditions standing orders come to the rescue of
nurse, they help her in providing treatment to the patient.

2. FEVER
• Examine the vital signs (temperature, pulse, respiration, blood
pressure).
• Gather information about other symptoms accompanying the fever
(to ascertain the cause of fever), like headache, uneasiness, nausea,
vomiting, shivering, cold, running nose, allergy, skin infection,
jaundice, fits, cough etc.
• Provide rest and light meal to the patient. Prepare blood slide to
examine malaria parasite (blood for MP) .
• Give paracetamol tablet to bring down fever. Give lot of liquids to
the patient. If fever is more than 39°C (102.2°F) give cold sponging to
patient.

3. HEAT STROKE
• Person suffering from heat stroke should be kept in the shade and a
well-ventilated place. Note the temperature, pulse, respiration and
blood pressure.
• Remove all clothes of the person and wrap him in a wet sheet. Keep
him wrapped in the wet sheet till the temperature falls at 38°C.
• If the patient is conscious, give him cold water mixed salt and other
cold drinks. Keep continuous observation over temperature.
• As soon as there is some improvement in the condition of the
patient, refer him to the hospital.

4. DIARRHEA
• Monitor the symptoms of dehydration. If the dehydration is severe or the
patient is in a state of shock, immediately refer him to the hospital.
Provide ORS to patient.
• Rice water, coconut water, lemon juice, light tea, banana, khichadi etc.
should be given to the patient. If there is epidemic of vomiting and
diarrhea, sample should be sent for stool test.
• If cholera is prevalent, then people should be immunized against it. Food
and water should be protected from getting infected and health officers
should be immediately informed (early notification). People should be
educated about controlling the files, cleanliness of water and food, and
proper disposals of excreta.
• Give medicines, as per the need.

5. BURNS
• Try to keep the burnt part of body immersed in water .Check the
spreading of burns.
• If the cloth has got stuck on the burned part, do not try to remove it.
though rings, bangles, shoes, belts and other tight fitted articles
should be removed. Do not touch the blisters unnecessarily.
• Cover the burnt part with a clean cloth. Assess the condition of the
patient and the percentage of burn. If the patient is in shock, give him
primary treatment.
• Give ORT to the patient (if he is conscious and not vomiting).

6. DROWNING
• Loosen the clothes from his chest.
• Make the person lie on his abdomen and get the water out of his
lungs.
• Resuscitate the patient and immediately send him to the health
center/hospital.

7. BITES
• Dog bite
• Thoroughly wash the wound with soap and water. Use running water.
Apply betadine or tincture iodine. If would is extensive, check
hemorrhage, but stitches should be done after 24 hours.
• If available ARS can be used for dressing but serum sensitivity test is
essential before use of it.
• Give injection of tetanus toxoid. Do not kill the dog and observe him
for 10 days.
• Send patient to hospital for ARV therapy.

8. SCORPIAN BITE
• Remove the sting and put ice on it, after thoroughly cleaning the
place.
• Apply tourniquet above the place of bite and remove it after half an
hour. Give analgesic tablets and also the sweetened milk to drink.
• If the patient is in shock, send him to the hospital.

9. FAINTING
Lie down the person. His head should be at a slightly lower level than
the feet.
If the person is sitting, keep his head bended between both the legs.
Person should get fresh air. There should not be any crowd around him
Once the person gains his consciousness, ask him to take deep breaths
and give him liquids to drink.
If the unconsciousness continues, send him for further treatment.