When to Go to the Hospital

A kidney infection is a serious condition that needs to be treated promptly. If left untreated, severe kidney infections can cause permanent damage. Please keep reading to learn how to recognize a kidney infection. We will also discuss when to go to the hospital and what you can expect in terms of kidney infection treatment.

What is a kidney infection?

A kidney infection is a type of urinary tract infection. To understand, let’s take a quick look at the organs of the urinary system. The urinary tract includes two kidneys, two ureters (a ureter is a narrow tube that carries urine from each kidney to the urinary bladder), the urinary bladder, and the urethra (a tube that allows the body to drain urine out). 

A kidney infection commonly begins in the urethra or urinary bladder, which is the lower urinary tract. This is frequently referred to as a urinary tract infection (UTI) or a bladder infection. Some UTIs get better on their own, but most do not. If left untreated, a UTI can spread to one or both kidneys and cause a kidney infection (medical term: pyelonephritis).

Kidney infections are dangerous because they can potentially lead to serious complications such as renal abscess, chronic kidney disease, kidney failure, high blood pressure, septicemia (bacteria in the bloodstream), shock, and even death. 

That’s why it’s important to seek prompt medical attention and get a proper kidney infection diagnosis and treatment from a healthcare provider.

What are kidney infection symptoms?

A kidney infection is a severe UTI of the upper urinary tract. Many symptoms of kidney infection feel similar to symptoms of lower urinary tract infections, i.e., urethra and bladder infections, such as:

• Pain or burning with urination
• Frequency and urgency to urinate
• Bad-smelling urine
• Cloudy or bloody urine

The following symptoms are also common with a severe kidney infection:

• Pain in the flanks (sides of the body) 
• Pain in the upper or lower abdomen
• Fever and chills
• Nausea and vomiting
• Mental status changes such as confusion and slurred speech in the elderly

How long can you let a kidney infection go?

You should not let a kidney infection go for even a few days. Seek medical attention as soon as you develop UTI symptoms. Lower urinary tract infections can quickly develop into kidney infections over a few hours to a few days. 

If your health care provider suspects a kidney infection, they will obtain a urine sample and order urine tests. Sometimes, they may order an imaging study such as a CT scan. 

If you have a kidney infection, they can prescribe oral medication if it is mild, because in moderate to severe cases it will be intravenous (kidney infections antibiotics). They may also give you pain medicine, such as nonsteroidal anti-inflammatory drugs, to relieve pain. 

When treated promptly with proper medical care, a kidney infection does not usually cause permanent kidney problems. 

If you have recurrent kidney infections, your primary care provider may refer you to a kidney specialist or urinary surgeon.

When should you go to the ER for a kidney infection?

You should go to the emergency room for a kidney infection if you have a high fever (over 101°F), severe pain, nausea, vomiting, or inability to stay hydrated. Basically, any suspicion of a kidney infection is a reason to go to the doctor.

When to go to the doctor for a kidney infection?

You should see your doctor as soon as possible if you think you have a kidney infection. In addition, see your healthcare provider if you’re on treatment for a UTI and your symptoms are not improving or are getting worse. 

Do you get hospitalized for a kidney infection?

The majority of kidney infections can be treated with a course of antibiotics at home. However, your doctor may admit you to the hospital for more serious kidney infections, so you can receive intravenous (IV) antibiotics. People with a weakened immune system or some other underlying medical problem may also require hospitalization for a kidney infection. 

Who is at risk of getting kidney infections?

Anyone can get a kidney infection. However, certain people are at a higher risk, such as

• Sexually active men and women who hold urine in or use spermicide and diaphragms.
• Women (the female anatomy makes it harder for the body to flush bacteria out). 
• Postmenopausal women, men with an enlarged prostate gland, and people with health conditions like urinary incontinence (urine leakage) and glycosuria (high glucose levels in urine).
• People with congenital abnormal anatomies, such as a misshapen urinary tract or vesicoureteral reflux (backflow of urine).
• Certain people who are genetically predisposed to repeated kidney infections. 

What can you do to prevent future kidney infections? 

A kidney infection develops when a UTI affecting the lower urinary tract (urethra and bladder) spreads upward. To prevent kidney infections, you need to prevent UTIs. You can do this by:

• Wiping from front to back after using the toilet. In women, this prevents bacteria from the anus from entering the urethra.
• Drinking fluids to flush out the urinary tract.
• Not holding urine in and using the bathroom as soon as you need to pee.
• Avoid using spermicide and diaphragms and use other birth control methods like condoms.
• Peeing after sex to reduce bacteria in the urethra. 
• Using vaginal estrogen to reduce vaginal dryness in postmenopausal women.
• Seeking prompt medical care for a UTI or kidney infection symptoms rather than relying on an over-the-counter pain reliever or home remedies like cranberry juice.
• Take the full course of antibiotics for UTI as prescribed by your doctor. 
• Do a lab test, such as a repeat urine culture test as recommended by your doctor to ensure that the infection is gone.

Can you take antibiotics long-term to prevent frequent UTIs?

You should only take antibiotics to prevent frequent UTIs under the guidance of your doctor. Overuse of antibiotics can lead to the development of antibiotic-resistant bacteria. If you have UTIs more than three times a year, your doctor may prescribe a low-dose antibiotic for prevention. Or they may ask you to start antibiotics at the first sign of kidney infection symptoms. Some people benefit from taking a single dose of antibiotics after sexual intercourse or at symptom onset to prevent severe kidney infection. The treatment plan will depend on your past medical history. Discuss the treatment options for UTI or kidney infection with your doctor before taking preventive antibiotics.

References:

1. https://www.mayoclinic.org/diseases-conditions/kidney-infection/symptoms-causes/syc-20353387

When To Go the ER for a UTI

Urinary tract infections (UTI) are very common. It is estimated that around 50–60% of women will develop at least one UTI in their lifetime. UTIs occur when bacteria (germs) get into the lower urinary tract and find themselves in the bladder or urethra. If a UTI is not treated quickly or adequately, the infection can move up the urinary tract and into the kidneys. Such complications are why it is important that UTIs are treated properly.

Risk Factors for Developing a UTI

One of the most important risk factors for developing a UTI is having been diagnosed with a UTI in the past. Unfortunately, having a UTI in the past makes you susceptible to having another one in the future. Other risk factors include:

• Frequent or recent sexual activity – sexual activity tends to increase the risk of a UTI. Having a new partner also increases the risk
• Contraception methods like diaphragms or spermicidal agents may increase the risk of a UTI
• Menopause -after menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to UTIs
• Certain medical conditions like diabetes can increase your risk of getting a UTI
• Pregnancy also increases the risk of developing a UTI. UTIs in pregnancy should always be taken seriously due to the potential complications that it can lead to

Symptoms of a UTI

When UTIs cause signs or symptoms these usually include:

• A frequent urge to urinate
• A burning sensation when urinating
• Urine that appears cloudy in colour
• Strong-smelling urine
• Urine that appears red, bright pink or cola-colour — a sign of blood in the urine

If the infection spreads to the upper urinary tract or to the kidneys (known as pyelonephritis), signs and symptoms may include:

• Back pain around upper sides or waist
• Fever or chills
• Nausea and/or vomiting

Diagnosis

Several methods may be used to determine whether you have a UTI.

• A urine sample may be used to evaluate the number of bacteria and white blood cells present.
• A pelvic exam may be needed to rule out a pelvic problem.

Management

Urinary tract infections are treated with antibiotics. Your doctor may recommend testing your urine after the treatment is finished to be sure the infection has completely cleared up. Some patients feel better within 24 hours of being on antibiotics, but it is important to take all of the medication provided to remove the bacteria.

Preventing UTIs

You can help prevent UTIs by practicing the following health habits:

• Practice good personal hygiene. Always wipe from front to back. Douching is not advised.
• Stay hydrated, drink plenty of fluids (at least three to four glasses of water each day) to help flush bacteria out of the urinary tract.
• Empty your bladder completely as soon as you feel the urge, or at least every three hours.
• Get plenty of vitamin C. It makes urine acidic and helps keep bacteria down. Vitamin C is found in orange juice, citrus fruits, and broccoli.
• Wear cotton underwear. Bacteria grow better in moist places. Cotton does not trap moisture.

If you contract a UTI or suspect you might have one, make an appointment to see your doctor.

References

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502981/
• https://www.cdc.gov/antibiotic-use/uti.html

Author: Life Savers ER Houston, TX

https://lifesaverser.com/

Life Savers 24 Hour Emergency Room is Your #1 ER Community Resource for Pediatric and Adult Medical Care Staffed by Emergency Physicians. Life Savers 24 Hour Emergency Room is equipped to handle life threatening conditions quickly. Our wait time is 0 to 5 minutes. We have a strict NO WAIT policy. Your emergency or concern is our priority! Life Savers 24 Hour Emergency Room is your ER for immediate definite care. Need a COVID-19 test or care? Do not hesitate to call us today or stop by our facility. Life Savers has 2 convenient Houston emergency rooms: Willowbrook, Heights, and Lake Houston Pkwy.

Medical consultations – Belovskaya ambulance station

ACUTE PAIN

Acute headache with weakness in the extremities

Put the patient in a serious condition on a flat surface, turn his head to one side (if there is no suspicion of a spinal injury!) and watch for the patency of his respiratory tract – in a timely manner, free the mouth and nasopharynx from saliva, mucus and vomit.

Acute abdominal pain

In case of sudden pain in the abdomen, never use a hot heating pad! Is it dangerous! Do not take painkillers and laxatives! With severe pain, you can apply ice for a short time.

Acute pain in the lower back

Pain in the lumbar region can have two origins:

Pain associated with the pathology of the kidneys and urinary tract , irradiates to the abdomen, along the ureter and to the perineum, to the genitals. In case of an acute attack of renal colic, use thermal procedures – a heating pad, a hot bath. This can be supplemented by taking antispasmodic and painkillers: cystenal 10-20 drops, a papaverine tablet, no-shpy, baralgin, spazgan or other similar drugs. If, during an attack of pain, blood appears in the urine, then thermal methods are not used. They only take painkillers. Pain associated with the manifestation of osteochondrosis and pathology of the lumbar roots – lumbago, sciatica. With lumbago, acute pain appears during physical exertion or awkward movement. The patient “freezes” in an uncomfortable position, cannot unbend due to pain. Lumbosacral sciatica is manifested by pain in the lumbar region radiating to one or both legs. May be accompanied by leg numbness, crawling sensation. First aid for such patients is placement on a hard bed, rubbing with irritating ointments (viprotox, viprosal, apizartron, finalgon, menovazin). Inside – analgesics (analgin, aspirin, indomethacin, orthofen, reopyrin).

Acute pain in the heart

Give the patient Validol, Corvalol or Valocardin. Only if these medicines do not work, put one nitroglycerin tablet under the tongue. In this case, the patient should lie on a flat surface. AT THE FIRST TIME APPEARING PAIN IN THE HEART, YOU SHOULD NOT START ASSISTANCE WITH NITROGLYCERIN.

HEMOPHILIA, BLEEDING IN THE PATIENT

Place a sterile pressure bandage over the bleeding site, if possible with a hemostatic sponge. Cold over bandage.

DIABETES, ACUTE DISORDER IN THE PATIENT

If the patient’s condition worsens, give him a glass of sweet tea or water with sugar to drink.

FOREIGN BODY

Foreign body in the eye

Do not attempt to remove chips, glass shards, or other objects embedded in the eyeball. Apply a sterile bandage to the eye. Contact a specialist immediately.

Foreign body in the nasopharynx

Do not try to remove a foreign body stuck in the nasopharynx – you can push it deeper. Contact a specialist immediately.

Foreign body in the esophagus

Try to remove the foreign body. Use the following technique – clasping the victim from behind in a standing position, put your fist on the stomach area, place your other hand on the fist and press hard with it from the bottom up under the chest. DO NOT SWALLOW ROUGH FOOD – BREAD CRUSTS, ETC. IN THE HOPE THAT SHE WILL PUSH IN THE FOREIGN BODY.

Foreign body in the trachea, bronchi.

Remove vomit and food debris from mouth with finger or tissue . Use the following technique – clasping the victim from behind in a standing position, put your fist on the stomach area, place your other hand on the fist and press hard with it from the bottom up under the chest.

Foreign body in the ear

Do not try to remove a foreign body stuck in the ear – you can push it deeper. If an insect enters the ear, inject a few drops of warm vegetable or vaseline oil, cologne or vodka into the ear.

BLEEDING

Bleeding after tooth extraction

Press the bleeding gum firmly with a piece of gauze soaked in calcium chloride solution.

Nosebleed

Have the patient sit up for nosebleeds. Put cold on the bridge of your nose.

Frostbite

Signs of frostbite
skin pale cyanotic, cold, sharply reduced or no sensitivity. On warming or rubbing, severe pain in limbs.

First Aid
In a warm room, warm the limb by first rubbing it with a dry, soft cloth. Then place the limb in a basin with warm water, gradually bring the water temperature to 40-45 degrees. If the pain disappears and the sensitivity is restored, then wipe the limb dry, put on dry socks or gloves. The victim needs to see a surgeon. If the pain during warming does not go away, and even intensifies, and the limb remains pale and cold, then the victim is immediately sent to specialist doctors.

Fainting

If you feel faint, lie on your back with your legs slightly raised. If this is not possible, sit on a chair and lower your head between your knees until you feel better. When fainting, first of all, check whether the patient’s breathing is normal. Lay it on your back with your legs as high as possible. Provide fresh air: unbutton the collar and tight clothes, open the windows. If you faint outside, make sure the person is lying in the shade. After regaining consciousness, the person should lie down for a few more minutes before rising.

BURNS

Eye burns

Rinse eyes with plenty of cold water. Drip the novocaine solution from the ampoule, carefully and carefully drawing it into the pipette.

Skin burns

Immediately apply cold to the burned surface – an ice pack with snow or cold water. You can wash the burnt surface with a stream of cold water. Do not try to clean the surface of the burn, forcefully separate adhered clothing, open blisters, apply any creams, ointments or powders, except those specifically designed for burns. Do not wash the burnt surface with urine! The victim can be given pain medication and diphenhydramine. Cover the burn with a sterile bandage and seek medical attention as soon as possible.

Burns of the esophagus

In case of burns of the esophagus with a cauterizing liquid – acid or alkali, do not induce vomiting or give the victim plenty of fluids – this worsens his condition. You just need to rinse your mouth with clean cold water.

HEART STOP

Signs of clinical death

no pulse on the carotid artery – on the lateral surface of the neck; pupils dilate and do not react to light; breathing stops – a mirror brought to the patient’s mouth does not fog up.

With signs of clinical death, the patient is placed on a hard, flat surface and a closed heart massage is performed simultaneously with mouth-to-mouth artificial respiration.

Closed heart massage

Place your hand on the lower part of the victim’s sternum, and with the palm of the other hand, press from above 60-70 times per minute. Keep the victim’s mouth and throat clean.

Mouth-to-mouth resuscitation
(performed at the same time as chest compressions): Tilt the victim’s head back. Cover the lips of the victim with your mouth, while pinching the victim’s nose with your fingers. Exhale into the victim’s mouth with a frequency of 1 time for 6-7 compressions on the sternum, while interrupting the heart massage. Artificial respiration should be continued even after the victim has spontaneous respiratory movements.

POISONING

The actions of the first responder depend on the type of poison. You can determine what the victim was poisoned by by empty vials, bottles, medicine packages, as well as by the smell from the victim’s mouth.

In case of acid and alkali poisoning

Do not give the victim to drink! In no case do not use acid or alkali solutions to neutralize the drunk substance! Don’t try to induce vomiting.

In case of poisoning with drugs and other substances

(not caustic acids or alkalis!), if the victim is conscious and able to swallow, give him plenty of clean water. Do not introduce any neutralizing substances internally. If the victim is unconscious, it is necessary to monitor the cleanliness of his respiratory tract and oral cavity by turning his head to one side. Tilt the victim’s head back.

Place your mouth around the victim’s lips while pinching the victim’s nose with your fingers. Exhale into the victim’s mouth with a frequency of 1 time for 6-7 compressions on the sternum, while interrupting the heart massage. Artificial respiration should be continued even after the victim has spontaneous respiratory movements. LIGHTNING

If there are no signs of life, initiate chest compressions and artificial respiration at the same time.

Closed heart massage
place the palm of your hand on the lower part of the victim’s sternum and with the palm of the other hand apply pressure from above 60-70 times per minute. Keep the victim’s mouth and throat clean.

Mouth-to-mouth resuscitation
(performed at the same time as chest compressions): Tilt the victim’s head back. Cover the lips of the victim with your mouth, while pinching the victim’s nose with your fingers. Exhale into the victim’s mouth with a frequency of 1 time for 6-7 compressions on the sternum, while interrupting the heart massage. Artificial respiration should be continued even after the victim has spontaneous respiratory movements. In no case do not use folk remedies – do not bury the victim in the ground, etc.! This will result in the death of the victim.

ELECTRIC SHOCK

Disconnect the victim from the source of voltage as soon as possible without being exposed to electric current (using dry wooden objects – boards, etc.). If there are no signs of life, start chest compressions and artificial respiration at the same time.

Closed heart massage
place the palm of your hand on the lower part of the victim’s sternum and with the palm of the other hand apply pressure from above 60-70 times per minute. Keep the victim’s mouth and throat clean.

Mouth-to-mouth resuscitation
(performed simultaneously with chest compressions): Tilt the victim’s head back. Cover the lips of the victim with your mouth, while pinching the victim’s nose with your fingers. Exhale into the victim’s mouth with a frequency of 1 time for 6-7 compressions on the sternum, while interrupting the heart massage. Artificial respiration should be continued even after the victim has spontaneous respiratory movements. In no case do not use folk remedies – do not bury the victim in the ground, etc.! This will result in the death of the victim.

MENTAL ILLNESS, ACUTE DISTURBANCE IN THE PATIENT

Before the psychiatrist arrives, try to find contact with the patient, calm him down. Encourage the patient to take a calming pill. To prevent aggression and self-harm, remove all piercing and cutting objects, do not let the patient near the window, do not let him go out onto the balcony.

Try to stop the bleeding by applying a tourniquet—rubber tube or tightly wound piece of cloth—over the wound for arterial bleeding (a pulsating stream of scarlet blood). Apply a tight compressive bandage – a tightly bandaged gauze roller or an unwound bandage – on the wound itself with venous bleeding (dark blood slowly flows out).

For capillary bleeding
(normal cut) the bleeding will stop spontaneously after a while, but applying a clean bandage will not hurt. If the bandage is soaked with blood, it is not recommended to change it.

ACUTE ALLERGIC REACTIONS

Signs of an acute allergic reaction

– red rash raised above the skin level, with severe itching and swelling. There may be a sensation of an enlarged tongue, difficulty swallowing and breathing. Before the doctor arrives, if possible, eliminate the cause of the allergy, give calcium chloride or calcium gluconate inside, as well as one of the tablets, as I have – suprastin, tavegil, diphenhydramine, diazolin, fenkarol, pipolfen. Be sure to see a doctor after emergency care.

SUDDEN LABOR

At more than 36 weeks of gestation, signs of incipient labor may appear – persistent pain in the lower back, cramping pain in the abdomen, discharge of a clear liquid from the vagina. No need to panic – these signs appear at the very beginning of labor and you have enough time to get to the maternity hospital!

SUICIDE ATTEMPT

Stressful state

Try to calm the person, give valerian tincture, Zelenin drops. Try to defuse the traumatic environment. Remove the person from the crowd, the street, or any other place where the stress has arisen.

HIGH TEMPERATURE

You can lower the high temperature as follows
give the patient an age-appropriate dose of aspirin or paracetamol. Make sure you drink plenty of soft drinks. Free the patient from excess clothing. Make sure that the room temperature does not exceed 15 degrees. In extreme heat, wiping with a sponge dipped in lukewarm water helps. Call a doctor .

INJURY

Eye injury

Apply a sterile dressing, if the wound is open, do not try to remove foreign bodies! Cold to injured eye.

Injury of the chest and abdomen

Closed injury – cold, open – sterile dressing. Do not give painkillers to the victim. Prolapsed organs cannot be repositioned.

Hand injury

In case of an open injury, use a sterile dressing. Try to stop the bleeding by applying a tourniquet – a rubber tube or a tightly twisted piece of cloth – above the wound in arterial bleeding (a pulsating stream of scarlet blood).

Apply a tight pressure bandage – a tightly bandaged gauze roll or an unwound bandage – to the wound itself in case of venous bleeding (dark blood slowly flows out).

Trauma to bones and joints.

Apply cold to the injured area as soon as possible, make a tight bandage.

Trauma of the facial skeleton

Cold on the face. Be sure to call your doctor.

MULTIPLE INJURY

Spinal injury

Lay the casualty on a flat, hard surface, such as a door that has been removed from its hinges. If there is no concomitant damage to the organs of the chest and abdomen, an anesthetic tablet can be given. CALL A DOCTOR IMMEDIATELY.

Injury of the skull

Lay the victim on a flat hard surface, turn his head to one side (if there is no spinal injury!) and monitor the airway – free the mouth and nasopharynx from vomit. The life of the victim depends on the patency of the respiratory tract. Put the cold on your head.

Traumatic amputations

Apply a sterile dressing to the wound. In case of arterial bleeding (scarlet blood spurts), apply a tourniquet above the wound for no more than 2 hours. ATTENTION! Replantation (engraftment) of the severed part of the limb is performed within 12 (in some cases up to 20) hours from the moment of traumatic amputation. Engraftment is possible only if the severed limb is properly stored until the victim is admitted to a medical institution. Put the cut part in a dry, intact and clean plastic bag, tie it up and place it in the second bag. Ice, snow or cold water should be placed at the bottom of the second bag. The cut off part must not come into contact with ice, snow or water.

SUDDEN CHOKING

In case of choking in a patient with bronchial asthma, heart disease, seat the patient with back support or astride a chair. For bronchial asthma, give an inhaler, inside – a tablet of theofedrine. If you have a heart condition, give a nitroglycerin tablet (if this is not the first time this has happened), again if necessary. If possible, call an ambulance and do not try to take the patient to the hospital.

CHANGING

In case of strangulation from an external cause (a person choked on something, a noose around his neck was tightened, etc.), this cause must be eliminated. Cut the loop around the neck, but do not untie the knot. Try to remove the foreign body from the respiratory tract with your fingers. If this is not possible, use this technique: grabbing the victim from behind in a standing position, put your fist on the stomach area, and place your other hand on the fist and press hard from the bottom up under the chest.

If there are signs of clinical death
(absence of pulsation on the carotid artery and respiration – the mirror brought to the mouth does not fog up), immediately begin to simultaneously conduct closed heart massage and mouth-to-mouth artificial respiration.

Closed heart massage
Place your hand on the lower part of the victim’s sternum and with the palm of your other hand apply pressure from above 60-70 times per minute. Keep the victim’s mouth and throat clean.

Mouth-to-mouth resuscitation
(done simultaneously with chest compressions): Tilt the victim’s head back.

DROWNING

When drowning, the victim is quickly laid on his stomach on the hip of the bent leg of the rescuer. Cover the lips of the victim with your mouth, while pinching the victim’s nose with your fingers. Exhale into the victim’s mouth with a frequency of 1 time for 6-7 compressions on the sternum, while interrupting the heart massage. Artificial respiration should be continued even after the victim has spontaneous respiratory movements. CONSULT A DOCTOR (head below the leg) and with sharp jerky movements compress the lateral surfaces of the chest (for 10-15 seconds), after which they turn it on its back. The oral cavity is cleaned with a finger wrapped in a handkerchief.

If there are signs of clinical death
(absence of pulsation on the carotid artery and breathing – the mirror brought to the mouth does not fog up) immediately begin to conduct simultaneously closed heart massage and artificial respiration “mouth to mouth” Closed heart massage, and with the palm of the other hand press from above 60-70 times per minute. Keep the victim’s mouth and throat clean.

Mouth-to-mouth resuscitation
(performed simultaneously with closed heart massage): Tilt the victim’s head back.

SNAKE BITE

Immediately suck the venom out of the wound with your mouth. Cover the lips of the victim with your mouth, while pinching the victim’s nose with your fingers. Exhale into the victim’s mouth with a frequency of 1 time for 6-7 compressions on the sternum, while interrupting the heart massage. Artificial respiration should be continued even after the victim has spontaneous respiratory movements. CONSULT YOUR DOCTOR. Suck out the contents of the wound for 10-15 minutes by spitting it out. Before this, open the wounds by squeezing the skin folds in the bite area. the procedure is safe, since snake venom that gets into the mouth and stomach does not cause poisoning. Make sure that the affected limb remains motionless. Lay the victim down and keep him calm. Let’s drink a lot.

BITE BY UNKNOWN ANIMALS

Thoroughly clean the wound with hydrogen peroxide or water, smear the edges of the wound with tincture of iodine, apply a sterile dressing. Tetanus and rabies vaccinations are required.

EPILEPSY

Protect the patient from head trauma and falling of vomit into the respiratory tract until the doctor arrives. Lay the patient on his stomach and turn his head to the side. Put something soft under the patient’s head. To prevent biting the tongue, insert a spoon wrapped in a handkerchief between the patient’s teeth. Move all nearby objects away, but do not try to hold the person. DO NOT PUT ANYTHING INTO YOUR MOUTH UNTIL CONSCIOUSNESS IS RETURNED, DO NOT GIVE NITROGLYCERIN!

Place your hand on the lower part of the victim’s sternum.

The patient’s right to adequate pain relief