For 24 hours General Medical Advice telephone 111 or visit the NHS 111 website.
Do I Need To See a Dr?
General Practice is overwhelmed with an ever increasing requirement to carry out the Government’s Public Health agenda of screening and primary and secondary prevention for conditions such as obesity, diabetes etc… and consequently it is extremely challenging to try and find enough time to meet basic patient appointment demands and needs. So please: “ Help Us to Help You…..” by not coming to see a doctor immediately you develop an acute illness that is likely to be viral—such as flu or a bad cough or cold.
The following conditions are genuine emergencies for primary care and need to be seen immediately and if we are not available go to a Walk-in Centre or Accident and Emergency:
Adults - it is difficult to speak a full sentence without stopping for breath or where the breathing is very laboured and much faster than usual
Small Child - if there is rib recession and the abdominal muscles are being used.
Rashes: (petechial rashes) which look like blood under the skin and fail the glass test ie they do not blanch when a glass is pressed against the rash but stay looking like blood under the skin. These may be due to meningococcal infection (meningitis and septicaemia).
Neck Stiffness and Light Sensitivity: If there is resistance in flexing the neck so that the chin can touch the chest and / or unusual sensitivity to bright light then meningitis needs to be excluded.
Extreme lethargy: Any sick child with a high temperature will be more sleepy and lethargic than usual. If this is continuous for more than a few hours the child needs assessment. With infectious illnesses the temperature will peak and trough. When it is close to normal the child will revert to being closer to normal in behaviour. When the temperature is very high the child will be more lethargic. It is where there is no reverting to normal that the child needs urgent assessment.
Abdominal Pain: When there is continuous or progressively worsening abdominal pain associated with either a temperature or vomiting or both then urgent assessment is indicated. This pain needs distinguishing from the intermittent abdominal cramps associated with diarrhoea due to a gastro-intestinal infection or food poisoning.
Acute onset of Chest Pain in Adults: This needs a 999 call for urgent assessment in A&E.
Loss of Consciousness or inability to move a limb: This needs a 999 call for urgent assessment in A&E.
Any other bizarre or alarming symptom of acute onset where there is no reasonable explanation.
In the absence of the above then any acute onset of an illness with a temperature is likely to be viral in the first instance:
Day 1-4 Common viral illnesses include: flu, the common cold, sore throats; gastro-intestinal upset/ diarrhoea and vomiting, viral headaches. The usual sequence of events is that for the first three to four days the temperature will be intermittently quite high. This will be associated with feeling shivery, alternating with feeling sweaty and very unwell. There may be a headache, fatigue/ tiredness runny nose, catarrhal symptoms, cough and cold as well and, in the case of flu, generalised aching muscles and joints. These symptoms are usually a bit less on the third day and beginning to improve by the fourth or fifth day.
Day 5 Although coughs and colds may last from 10 days to 3 weeks, by the fifth day there is usually a noticeable improvement. The temperature should be back to normal. This improvement should continue after the fifth day and recovery back to normal health should occur over the following week or so.
After Day 5 If there is a return of a raised temperature after day 5 or if any of the symptoms are not continuing to improve or especially if they are getting any worse, then there is a real risk that there is “Secondary Bacterial Infection", and these need treating with antibiotics and the sooner the better. This is the time to contact your GP practice when a clinician will determine if antibiotics are needed.
Please note that there is no treatment that helps very much with common viral illnesses but your local Pharmacy are the best people to advise on paracetamol, cough linctus, etc.
Back pain causes 13 million working days to be lost in Britain each year.
Symptoms usually respond to 24 hours rest lying on a firm bed followed by gentle exercise and return to normal activities.
Paracetamol or Ibuprofen will help to relieve pain and local heat from a hot water bottle may also help.
Avoid straining your back while exercising and take great care with lifting even when the pain has subsided
When sitting, an upright chair with support for the small of the back lessens strain on the spine.
If the pain does not start to improve within a few days, then consult your doctor for advice.
Insect Bites and Stings
Most need no treatment.
Anti-histamine tablets and/or cream can be obtained from the chemist without prescriptions and will relieve most symptoms.
Apply large quantities of cold water to the affected area as soon as possible and continue until the pain subsides: but running cold water is the most effective.
This may take some time. If the skin is unbroken but blisters, apply a loose dry dressing.
If the burn is larger than 10cm (4 inches) in diameter or if the skin is broken, consult your doctor as soon as possible.
Do not use creams such as Germoline or Savlon
On the first day a rash appears with small red spots.
Within a few hours these develop small blisters at the centre.
Over the next 3 or 4 days further spots will appear and the earlier ones will turn crusty and fall off.
Calamine lotion will soothe the itching and cool baths may help.
The most infectious period is 2 or 3 days before the rash appears and until the last crusts have formed dry centres, usually 7-10 days after the onset of the rash.
Children may return to school as soon as the last crusts have dropped off.
The incubation period of chicken pox is 14-21 days.
Colds and Flu
These usually start with a runny nose, cough, temperature and muscular aches.
They are usually caused by viruses for which antibiotics will have no effect.
Paracetamol helps the temperature and aches whilst decongestants and throat lozenges may also help to relieve symptoms.
It is important to drink plenty of fluid, but do not worry if you do not eat for a few days - you will come to no harm
However no more than eight paracetamols should be taken within any 24 hours
Diarrhoea and Vomiting
In adults and older children, diarrhoea and vomiting is usually caused by a virus.
Treatment consists of replacing fluid lost with small amounts of water, or fizzy lemonade taken frequently and not eating for 24 hours.
If the diarrhoea contains blood, if there is severe pain or high fever you should consult your doctor.
Diarrhoea and vomiting in small babies and young children should be treated with caution and your doctor will be happy to advise you over the phone and arrange to see you if necessary.
Elderly people and those with medical conditions (e.g. diabetes) should consult a doctor.
Women taking the oral contraceptive pill may need to take extra precautions.
These creatures prefer clean hair and are not a sign of poor hygiene.
Daily combing with a fine tooth comb after application of conditioner is also effective
This is an infection of the covering of the brain and the most serious from is caused by the meningococcus bacteria and requires urgent medical attention.
Warning signs include a "blood spot" rash that does not blanch under pressure, and neck stiffness.
In infants there may be drowsiness, change in the cry, irritability, fever, diarrhoea or vomiting.
In adults, as well as neck stiffness and rash there may be high temperature, vomiting, headache and back or joint pains
- Blanch = press the side of a clear drinking glass onto the rash or bruises and checking that they fade.
Sit in a chair (leaning forward with your mouth open) and pinch your nose just below the bone for 10 minutes, by which time the bleeding should have stopped.
If the bleeding continues or if your are taking blood-thinning tablets (anticoagulants): consult your doctor.
Avoid blowing your nose for 48 hours and hot food and drink for 24 hours.
Sprains and Strains
Apply a cold compress (e.g. a packet of frozen peas wrapped in a wet tea towel) to reduce swelling: then apply a firm crepe bandage and give the sprain plenty of rest until the discomfort has subsided.
Try to prevent this by avoiding exposure to the sun in the heat of the day and using sun screens.
Treat sunburn by cooling the skin with cool water or calamine lotion and take Paracetamol or anti-histamine tablets as necessary.
A raised temperature occurs commonly even with mild infections.
In small children it is important to stop the temperature rising too quickly and they should be given Paracetamol syrup which may be bought from the chemist.
If they are still feverish they should be gently sponged with tepid water as in a bath or shower to cool them (this may take up to 20 minutes)
If a temperature is very high and does not come down with this treatment or the child appears very unwell you should consult your doctor.
A child or adult with a temperature will not come to any harm being brought by car or by pram to the surgery.