WHERE THERE IS NO DOCTOR HOW TO EXAMINE A SICK PERSON
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Md-21
chapter
How to Take Care
of a Sick Person
This is a reprint from
Where 'There Is No Doctor
(Indian adaptation)
published by the
Voluntary Health Association of India
C-14 Community Centre
Safdarjung Development Area
New Delhi 110016
49
CHAPTER
How to Take Care
of a Sick Person
Sickness weakens the body. Special care is neededto gain strength and get well
quickly
The care a sick person receives is o hen
the most important part of his treatment.
Medicines are often not necessary. But good care is always important. The
following are the basis of good care:
1.
The Comfort of the Sick Person
A person who is sick should
rest in a quiet, comfortable place
with plenty of fresh air and light.
He should keep from getting too
hot or cold. If the air is cold or
the person is chilled, cover him
with a sheet or blanket. But if the
weather is hot or the person has
a fever, do not cover him at all (see p. 87;).
2. Liquids
In nearly every sickness, especially when there is
fever or diarrhea, the sick person should drink
plenty of liquids: water, tea, juices, broths, etc.
3. Personal Cleanliness
It is important to keep the sick person
clean. He should be bathed every day
If he is too sick to get out of bed,
wash him with a sponge dr
cloth and lukewarm water. His
clothes, sheets, and covers
must also be kept clean.
Take care to keep crumbs and
bits of food out of the bed.
A SICK PERSON SHOULD
BE BATHED EACH DAY
50
4. Good Food
If the sick person feels like eating, let him. Most
sicknesses do not require special diets.
A sick person should drink plenty of liquids and eat body-building
and nourishing foods like dal. beans, green leafy vegetables, fruits and milk
If possible try to eat eggs, meat.fish and chicken. Milk is very good as it
contains the substances the body needs (see chapter 11)
If the person is very weak, give him these same foods, but make them into
soups or juices.
Energy foods are also important—for example, porridges of rice, wheat,
corn,maize and ragi- Adding a little sugar and vegetable oil will increase the
energy. Also encourage the sick person to drink plenty of sweetened drinks,
especially-if he will not eat much.
A few problems do require special diets. These are explained on the following
pages:
stomach ulcers and heartburn........................................ p 149'
appendicitis, gut obstruction, acute abdomen
(in these cases take no food at all)............................... p 106
diabetes................................................................................ p. -149
heart problems.................................................................. p. 371
gallbladder problems......................................................... p. 375
Urinary tract infection in children.
p.357
SPECIAL CARE FOR A PERSON
WHO IS VERY ILL
1. Liquids
It is extremely important that a very sick person drink enough liquid. If he only
can drink a little at a time, give him small amounts often. If he can barely swallow,
give him sips every 5 or 10 minutes.
51
Measure the amount of liquids the person drinks each day. An adult needs to
drink 2 liters or more every day and should urinate 3 or 4 times daily. If the
person is not drinking or urinating enough, or if he begins to show signs of
dehydration (p. 181) encourage him to drink more. He should drink nutritious
liquids, usually with a little salt added. If he will not drink these, give him
Rehydration Drink (see p. 182). if he cannot drink enough of this, and develops
signs of dehydration, a health worker may be able to give him intravenous
solution. But the need for this can usually be avoided if the person is urged to
take small sips often.
2.
Food
If the person is too sick to eat solid food, give him soups, curds, lassi.
dal water, vegetable soup, lime juice, coconut water and other
nutritious liquids. (See chapter 1 1).
A porridge of rice, wheat dalia. suji or ragi is also good, but should be
given together with body building foods. Soups can be-made with green
leafy vegetables.beans, eggs, well chopped meat.fish or chicken. If a person can
eat only a little at a time, he should eat several small meals each day.
3.
Cleanliness and Changing Position in Bed
Personal cleanliness is very important for a seriously ill person. He should be
bathed every day with warm water. Change the bed clothes daily and each time ■
they become dirty.
A person who is very weak and cannot turn over alone should be helped
to change position in bed many times each day. This helps prevent bed sores (see
p.255).
A child who is sick for a long time should be held frequently on his mother's
lap
•requent changing of the person's position also helps to prevent pneumonia, a
constant danger for anyone who is very weak or ill and must stay in bed for a long
time. If the person has a fever, begins to cough, and breathes with fast, shallow
breaths, he probably has pneumonia (see p.208).
4.
Watching for Changes
You should watch for any change in the sick person's condition that may tell
you whether he is getting better or worse. Keep a record of his 'vital signs'. Write
down the following facts 4 times a day:
52
temperature
(how many degrees)
pulse
(beats per minute)
breathing
(breaths per minute)
Also write down the amount of liquids the person drinks and how many times
a day he urinates and has a bowel movement. Save this information for the health
worker or doctor.
It is very important to look for signs that warn you that the person's sickness is
serious or dangerous. A list of Signs of Dangerous Illness is on the next page. If •
the person shows any of these signs. Seek medical help immediately.
Y
SIGNS OF DANGEROUS ILLNESS
A person who has one or more of the following signs
is probably too sick to be treated at home without
skilled medical help. His life may be in danger. Seek
medical help as soon as possible. Until help comes,
follow the instructions on the pages indicated.
page
1.
Loss of large amounts of blood from anywhere in the body ...95,310, 327
2.
Coughing up blood...............................................................................................219
3.
Marked blueness of lipsand nails (if it is new)..................... 36,92, 204. 371;
4.
Great difficulty in breathing; does not improve with rest...........
204,371
Ex
The person cannot be wakened (coma).......................... ................................... 90
6.
The person is so weak he faints when he stands up................................... 371
7.
A day or more without being able to urinate............................................... 278
8.
A day or more without being able to drink any liquids. ......... ........... . . .181
9.
Heavy vomiting or severe diarrhea that lasts for more than
one day or more than a few hours in babies.....................................................181
10.
Black stools like tar, or vomit with blood or feces...................................... 150
11.
Strong, continuous stomach pains with vomiting in a person
who does not have diarrhea or cannot have a bowel movement................... 108
53
35.44
12.
Any strong continuous pain that lasts for more tnan 3 days ...
13.
' Stiff neck with arched back, with or without a stiff jaw
222, 225
14.
More than one fit (convulsions)
in someone with fever or serious illness
88 224
15.
High fever (above 39° C) that cannot be
brought down or that lasts more than 4 or 5 days
16.
Weight loss over an extended time
88
............................................... 28
17.
Blood in the urine
18
Sores that keep growing and do not go away with treatment ... . 232 238
252 253
19.
A lump in any part of the body that keeps getting bigger
20.
Problems with pregnancy and childbirth:
278
any bleeding during pregnancy
238,326
295, 327
swollen face and trouble seeing in the last months
295
long delay once the waters have broken and labor has begun
313
Severe bleeding
...........................................................................318
WHEN AND HOW TO LOOK FOR MEDICAL HELP
Seek medical help at the first sign of a dangerous illness. Do not wait until the
person is so sick that it becomes difficult or impossible to take him to a healthcenter or hospital.
If a sick or injured person s condition could be made worse
by the difficulties in.moving him to’a health center, try to
brrng a health worker to the person. But in an
emergency when very special attention or an
operation may be needed (for example, !
appendicitis), do not wait for the health
worker. Take the person to the health
center or the hospital at once.
When you need to carry a
person on a stretcher, make sure
he is as comfortable as possible
and cannot fall out. If he has any
broken bones, splint them before
moving him (see p.112). If the
sun is very strong, rig a sheet
over the stretcher to give shade
yet allow fresh air to pass under
neath
LIBRARY
AND
DOCUMENTATION
UNIT
J
54
A BICYCLE AMBULANCE
You can make a simple, inexpensive bicycle ambulance for your village. It is not
necessary to purchase a bicycle. You can use one that belongs to someone who is
helpful in your village.
Materials:
•
’
’
•
*
two thick wooden or bamboo poles 2'/z metres long
strong canvas or other cloth 2'4 metre long and 90 cms wide
one sheet to cover the patient
a metal or heavy bamboo or wooden frame to hold the stretcher—2 metre 35 cms
long and 56 cms wide.
canvas strips 2 cm wide and at least 1 metre 80 cms long
a pair of bicycle wheels fitted into a metal frame Your village
blacksmith can make this.
one metal ring welded on the rear frame of the bicycle
one L-shapped piece of metal fastened to the front of the rack which carried the
stretcher. This will fit into the metal ring of the bicycle and will hitch the bicycle
to the stretcher.
Instructions:
Fold the long ends of the cloth on both sides and stitch it well, so that the bamboo or
wooden poles can fit into them. Be sure to stitch very well with strona thread so
it does not open.
In the frame which holds the stretcher, cut deep groves so that the handles of the
stretcher will fit properly, and will not fall off when the bicycle moves. You may also
tie the handles to the frames as an added precaution.
Lift the injured person on tc the stretcher as shown on page. 113 and j 14
When the stretcher is secure on the frame..cover the person with a sheet. Tie the
person with broad canvas bands to the stretcher.
Drive carefully, avoiding jolts and short turns.
This type of ambulance is particularly useful if the health centre of hospital is very far,
and if the injured or sick person has to be taken immediately for medical help.
WHAT TO TELL THE HEALTH WORKER
For a health worker or doctor to recommend treatment or prescribe medicine
wisely, he should see the sick person. If the sick person cannot be moved, have
the health worker come to him. If this is not possible, send a responsible person
who knows the details of the illness. Never send a small child or a fool.
When you send someone for medical help,
always send a completed information form with him.
The book Where There Is No Doctor is available
at Rs 29/- plus postage.
Multiple copies of reprints
of various chapters are also available.
Please write to:
Publications Officer
Voluntary Health Association of India
C-14 Community Centre
Sa fdarjung Development Area
New Delhi 110016
Rs. 2-00
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