When should I see a doctor or nurse?

If your wound is large, soiled, needs stiches, or shows signs of infection, see a doctor immediately. A deep, gaping, or jagged cut that goes right through the skin will most likely need stitches. If your cut is not very deep, it will probably not need stitches. If in doubt, check with your doctor or nurse.

How do I take care of a cut or scrape?

1)     Clean the wound

Wash your wound thoroughly with soap and water. If, after washing, there is still dirt, glass, or another substance in your cut, see a doctor or nurse.

2)     Stop the bleeding

If your wound is bleeding, firmly press a clean cloth or bandage on it for 20 minutes. You can also help slow the bleeding by holding the cut above the level of your heart. If the bleeding doesn't stop after 20 minutes, see your doctor or nurse.

3)     Protect the wound

If available, apply a thin layer of antibiotic ointment (e.g. Bactroban) to the wound. Dress your cut with a clean, dry bandage and change the dressing 1- 2 times a day until the wound heals. Most cuts and scrapes heal on their own within a week, forming a scab in the process. Avoid touching or scratching the scab as this will increase the risk of bleeding, infection, and scarring. If your wound has been treated by a doctor, follow their instructions.

4)     Check for signs of infection

Symptoms of infection include: fever, discharge (e.g. pus), a bad odor, increased pain, redness, swelling, warmth, or red streaks around the edge of the cut. 

Do I need a tetanus shot?

It depends on how old you are and when your last tetanus shot was. Tetanus is a serious infection that causes fever, muscle stiffness, and can even lead to death. It is caused by bacteria found in dirt.

Most children are vaccinated as part of a routine checkup. After three initial doses of the tetanus vaccine (TD, TDAP), regular booster shots are needed to maintain an effective level of protection, usually every 10 years. It’s also common for adults to be vaccinated or receive a booster during a routine checkup. Check your vaccination record if you have one, or check with your doctor.

For simple wounds (e.g. closed, shallow, or clean), you will need a tetanus booster if you haven’t received one in the last 10 years.

For serious wounds (e.g. open, deep, punctured, or soiled with dirt), you will need a tetanus booster if you haven't had one in the last 5 years.

If you have a serious wound and you haven't received all of your tetanus vaccines (or you’re not sure if you have), you will need a tetanus booster shot and another shot of immunoglobulins to fight any tetanus bacteria that may have contaminated the wound.

Please be aware that supplies of the tetanus vaccine are not always stable in China and availability cannot be guaranteed. It is recommended that you get regular, preventative booster shots to avoid the need for urgent doses.

How do vaccines work?

When pathogens like virus or bacteria enter our bodies and our bodies do not produce enough antibodies to fight them away, we fall sick. 

Vaccines are made from a killed, weakened, or portion of virus or bacteria. Once injected into our bodies, the bodies will create the antibodies against the particular disease. When the virus or bacteria enter our bodies again, our body will recognize this disease and “fight” it.

How do vaccines protect my loved ones and me?

Vaccination builds up your immunity against the disease you are vaccinated. They are the safest way to protect you, your loved ones and your community from serious and sometimes deadly diseases. 

If only a few are immunized, contagious diseases spread easily from one to another. When enough people are immunized, you and your loved ones will be protected from the diseases.

What are the diseases that can be vaccinated for protection?

This information will help you to:

•      Learn about asthma

•      Understand the types of medicines used to treat asthma

•      Know when to seek medical care

What is asthma?

Asthma is a disease of the bronchioles, the tubes that carry air to the lungs.

When someone has an acute asthma attack, the airways get narrow and may fill with mucus. This makes it hard to breathe. For someone having an asthma attack, it’s like breathing through a narrow straw.

What are the symptoms of asthma?

Symptoms can be different between adults and children. They also vary among individuals. Depending on how fast and how serious the symptoms are, each asthma attack can be very different.

Early symptoms may include:

•      Coughing

•      Wheezing

•      Difficulty speaking

•      Chest tightness

•      Trouble breathing

•      Trouble exercising or playing

How will my doctor treat my asthma?

Inhalers and medicine delivery devices

Most asthma medicines are kept in a small, handheld device called an inhaler. To help the medicine reach the lungs more easily, your child may also use a spacer or a valved holding chamber as an add-on device. Most children can be taught to use inhalers directly or with the right spacer device.

A child who cannot use an inhaler may need to use a nebulizer. This device turns the liquid medication into a mist that can be inhaled through a mouthpiece or mask.

Quick-relief or “rescue” medicines

These medicines are also called bronchodilators. They help to open the bronchioles, making it easier to breathe. Used to treat an acute asthma attack, rescue medicine should be used when asthma symptoms first occur. 

The most common rescue medicine used is albuterol (Ventolin).

Long-term controller maintenance medicines

Controller medicines are used daily to keep asthma under control, reducing the severity and frequency of attacks.

Types of controller medicines include:

1. Inhaled corticosteroids 

These medicines help to decrease swelling and inflammation, making asthma attacks less frequent. They are usually taken every day, even if your child is not experiencing any symptoms.

Examples include Flixotide and Pulmicort.

2. Long-acting bronchodilators  

These help keep the airways from narrowing. They are usually used along with inhaled corticosteroids.

An example includes Seretide.

Oral steroids

Your doctor may recommend steroids taken by mouth (in pill or liquid form) if the asthma is not well controlled. They reduce inflammation and can help the airways become more responsive to inhalers. Steroids usually start to work within about six hours so are not used in acute attacks. Your child should continue to take quick-relief and long-term controller medications while taking oral steroids.

What else do I need to know about asthma?

Follow all instructions you have been given about treating and controlling asthma, including:

•      Recognizing and avoiding asthma triggers

•      Having an asthma action plan with your health care provider

•      Knowing how to use inhalers and related medicine delivery devices 

•      Knowing how to care for, store, and clean the inhaler mouthpiece, face mask, spacer, and valved holding chamber

•      Knowing how to refill prescriptions

When should I seek emergency care?

If your child has any of these warning signs, call 120 or seek emergency medical care immediately.

When your child has been diagnosed with asthma, it is important that he or she is monitored by a healthcare provider. Be sure to take your child to all follow-up healthcare appointments.

A urinary tract infection (UTI) is an infection of the urinary tract, which is the path that urine takes when it leaves the body. The parts of the urinary tract that can be infected include the bladder, urethra, and/or kidneys. The following terms refer to the place that is infected.

•      Cystitis (bladder Infection)

•      Urethritis (urethra infection)

•      Pyelonephritis (kidney infection)

It is important to treat UTIs to keep your kidneys healthy.

What causes a UTI?

UTIs, bladder infections in particular, are usually caused by a type of germ (bacteria) called Escherichia coli (E. coli). These bacteria are usually near the anus (the opening through which the feces leave our body). 

Some other bacteria, for example sexually transmitted infections like gonorrhea, chlamydia, and vaginal infections, can also cause UTIs affecting the urethra.

Who has a higher chance of developing a UTI?

Women in general have a higher risk of getting a UTI than men, because the distance between the opening of the urethra and the anus is shorter in women.

The chance of getting a UTI is also increased for people who:

•       Are sexually active or engage in anal sex

•       Use diaphragms or spermicide for birth control

•       Are pregnant or menopausal

•       Have a history of bladder or kidney infection

•       Have conditions that change or block the natural flow of urine, such as kidney stones

•       Have diabetes

Do I need to send my urine for culture to identify the bacteria?

Based on your symptoms, your doctor will decide if you need a urine culture. Your doctor may request for a urine culture test if the UTI is more than a simple bladder infection or if you are pregnant or have repeat infection.

How will my doctor treat my UTI?

Your doctor will give you antibiotic pills to eliminate the bacteria. It is important that you complete the course.

Depending on your symptoms, your doctor may also give you medicine to reduce discomfort and the urge to urinate.

Feel free to talk to your pharmacist about the common side-effects and allergic reactions for the relevant medicines.

What can I do at home to feel better?

•      Continue to finish all the antibiotic pills, even if you start to feel better

•      Drink plenty of water. This helps to flush the bacteria out of the body

•      Avoid caffeine and alcohol. They can irritate your bladder

•      Apply a warm pad to your abdomen to reduce bladder discomfort

How can I prevent getting a UTI again?

DOs

•      Drink plenty of water

•      Practice good perineal hygiene. Always wipe from front to the back

•      Wear cotton underwear. Bacteria grows better in moist places. Cotton does not trap moisture

•      Drink more fluid and void before and after intercourse

DON'Ts

•      Avoid holding your urine. Go to the toilet when you need to

•      Avoid soaking in bathtubs for long periods of time

When should I see my doctor again?

Please contact your doctor if you have any of the following:

•      Persistent discomfort or a condition which worsens after two days of antibiotic therapy 

•      Fever. A temperature higher than 38°C

•      Chills or night sweats

•      Severe flank, back, or abdominal pain

•      Severe nausea, vomiting, or diarrhea

•      Blood in urine

Sore throats are common. A sore throat is often a throat infection or pharyngitis.

Sore throats are usually caused by 2 types of germs—viruses and bacteria. Most sore throats are caused by viruses. Only 10% of sore throats are caused by bacteria. 

You or your child has seen the doctor and is likely to have a sore throat caused by a virus.

Do I need antibiotics?

If your sore throat is caused by a virus, you do not need antibiotics. A sore throat caused by viral infection gets better on its own with at-home care, usually within five to ten days.

What medicines will my doctor give me? 

Your doctor will most likely give you medication and lozenges to relieve your throat pain or discomfort. Depending on your symptoms, doctor may also give you medicines to relieve running nose and cough.

What about alternative remedies?

There are limited evidences on what works and what does not for common alternative remedies. Some of these remedies may not be safe. Check with your doctor before using them.

What are the things I can do at home to feel better?

DOs

•      Get plenty of sleep and avoid talking

•      Drink plenty of fluids to keep your throat moist. This helps with swallowing and prevents dehydration

•      Drink soothing beverages and eat soft foods

•      Gargle with salt water several times a day to help relieve throat pain

•      Add moisture to the air in your home. Use a cool-mist humidifier or vaporizer. Be sure to clean it daily

DON'Ts

•      Avoid spicy foods or acidic foods that irritate your throat

•      Avoid smoking or secondhand smoke

How much salt should I put in my salt water gargle?

About 1/4 to 1/2 a teaspoon (1.5 to 3.0 g) of salt in one cup (250 ml) of warm water.

When can I return to work? When can my child return to school?

You can resume your usual activities as soon as you feel better. Wear a mask if the air pollution is bad to prevent further throat discomfort.

How can I avoid getting a sore throat again?

Reduce your chance of having a viral infection by exercising regularly and eating healthily.

Also practice good hand washing habits, washing your hands with soap and water to prevent the spread of infection.

When should I see my doctor again?

Please contact your doctor if your sore throat does not improve within two days or if you have a fever. 

Also contact your doctor if you have the following symptoms: 

•      Difficulty swallowing

•      Drooling (especially for children)

•      Trouble talking or opening your mouth

•      Hoarseness lasting more than two weeks

•      Body aches, joint pain, or earache

•      Skin rash

•      Nausea or vomiting

•      Constant sleepiness or tiredness

•      Increased thirst or dry and sticky mouth with less urine than usual (one wet diaper or void in six hours) or total lack of tears when crying

When do I need to go to the hospital or emergency department?

Call the ambulance or go to the nearest hospital right away if you have: 

•      Chest pain

•      Difficulty breathing

•      Shortness of breath

With reference to www.uptodate.com

Everyone has blood pressure. Blood pressure is the force of the blood against the walls of your blood vessel walls. 

Some people have blood pressure that is higher than normal. When that happens, we call the condition high blood pressure or hypertension. When your blood pressure is higher than normal, your heart works harder to pump blood. 

When your blood pressure remains high for a long period of time, your arteries can get blocked or damaged, and cause the following problems:

What do the 2 numbers in my blood pressure reading mean?

The top number is the pressure in your arteries when your heart is contracting. The bottom number is the pressure inside your arteries when your heart is relaxed.

What is a healthy blood pressure reading?

The following is a guide to know your blood pressure condition (adults):

Will I know when my blood pressure is high? 

High blood pressure, unless very high or present for many years, usually has no symptoms. Many people do not know when their blood pressure is high. The best way to find out is to have your blood pressure checked by your doctor or nurse. 

It is recommended that all individuals 18 years or older be screened for high blood pressure. Measuring blood pressure is a simple and quick procedure that can be done in most clinics.

What causes blood pressure to become high?

The exact cause of high blood pressure is unknown, however there are several factors that in combination may cause the blood pressure to become high. These factors include smoking, obesity, sedentary lifestyle, and genes.

How can I prevent my blood pressure from becoming high?

The following can help to control your blood pressure from becoming high:

Bedroom and Living Room

•      Cover your pillows and mattresses with special zippered covers that keep dust mites away

•      Use washable blanket instead of a comforter

•      Use washable, vinyl or roll-type window covers

•      Use washable rugs instead of carpets

•      Vacuum floor and mattress weekly using a vacuum cleaner that has a ''HEPA filter'' (HEPA filter: High efficiency particulate air filter)

•      Every week, wash the following in hot water with detergent or dry them in an electric dryer:

•      If possible remove soft toys, clutter and fabric-covered furniture

Bathroom

•      Every 4 weeks, dilute 30 ml bleach in 1 liter of water, clean the sinks, tubs, surfaces with visible mold

•      Avoid using strongly scented aerosol air fresheners

Kitchen

•      Well-ventilate cooking areas

•      Kill cockroaches by using multiple baited traps or poison

•      Remove cockroach debris quickly

•      Remove garbage and food waste promptly

•      Wash dishes and cooking utensils immediately after use

•      Keep kitchen sink and drains dry. Mend leaking faucets or drains

Air quality

•      Air the room well if you have new furniture or carpet

•      If air pollution is bad, keep windows and doors closed

•      Reduce moisture in the air to less than 50%. Avoid using a humidifier

•      Keep your home smoke-free

Pets

If you can,

•      Keep all animals outside of the house 

•      After that, clean your home thoroughly

If you cannot remove your pets,

•      Use an air filter with a ''HEPA filter''

•      Reduce clutter in your home where allergens can build up (especially carpets, fabric-covers, etc.)

•      Vacuum floor with a vacuum cleaner that has a ''HEPA filter'' weekly

•      If you have a dog, bathe your dog 2 times a week

Upper respiratory infection (URI), also known as the common cold, is caused by a group of viruses. They can be passed between people by sneezing, coughing, and touching surfaces with the viruses on them. You can become infected if the lining of your eyes, nose or mouth comes in contact with the virus when you rub your nose or touch your face with contaminated hands. The usual symptoms are nasal congestion, runny nose and sneezing. 

The common cold weakens your immune system and at times leads to a new viral infection or bacterial infection. This can cause other serious problems such as sinusitis, infection of the middle ear, and pneumonia. Thus it is important that you take good care of yourself when you get the common cold to prevent these problems.

Do I need antibiotics?

Antibiotics are not useful for treating the common cold. If fact, taking antibiotics when not needed can negatively affect your health. The common cold gets better on its own with at-home care over time, even without any treatment. 

What medicines will my doctor give me? 

Depending on your symptoms, your doctor may give you medicines to relieve your runny nose, nasal congestion, cough, pain, or fever.

What can I do at home to feel better?

DOs

•      Get plenty of rest

•      Drink lots of fluids to keep the lining of your nose and throat moist

•      Add moisture to the air in your home. Use a cool-mist humidifier or vaporizer and be sure to clean it daily

DON'Ts

•      Avoid smoking or secondhand smoke

•      Avoid blowing your nose forcefully

When can I return to work? When can my child return to school?

You can resume your usual activities at least 24 hours after your fever totally subsides and when you feel better. Wear a mask if you still have a cough or runny nose, and practice good hygiene etiquette, like covering your mouth when sneezing or coughing to prevent the spread of infection.

How can I prevent getting a URI again?

Reduce your chances of getting a viral infection by exercising regularly and eating healthily.

Good hand washing habits, like washing your hands with soap and water before eating or after touching dirty surfaces, can prevent the spread of infection. 

Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available. Ensure that you thoroughly wash every part of your hands.

When should I see my doctor again?

Please contact your doctor if you have: 

•      Worsening symptoms after 3 to 5 days

•      A fever of 38.5°C or above lasting more than three days

•      Nasal congestion that does not improve over 14 days

•      Signs or symptoms of an ear infection - pain, ear discomfort, discharge from ear, difficulty hearing, fussiness (children), etc.

•      Severe body aches, joint pain

•      Rash

•      Nausea or vomiting

When do I need to go to the hospital or emergency department?

Call the ambulance or go to the nearest hospital right away if you have: 

•      Chest pain

•      Difficulty breathing

•      Shortness of breath

•      For children:

  ○  Increased irritability or decreased responsiveness

  ○  Poor oral fluid intake

Allergic rhinitis (AR) is caused by small airborne particles that behave as allergens in our nasal passages. These allergens provoke an allergic reaction and our body produces substances that cause swelling and congestion (inflammation). When this happens, it is known as rhinitis. AR often runs in families.

The usual symptoms are an itchy runny nose and sneezing. Sometimes, the mucus from the nose will run down the back of your throat (postnasal drip). For some, the symptoms go beyond the nasal passages and affect the eyes, ears, throat, and even sleep.

AR can be seasonal (occurring during specific seasons) or year-round. Seasonal AR allergens include pollens from trees, grasses, and weeds. Year-round AR allergens include dust mites, cockroaches, animal dander, etc. For some people. this becomes a lifelong condition that waxes and wanes over time.

What medicines will my doctor give me? 

Your doctor will provide you with devices you can use to rinse your nose. Besides helping to clean the insides of the nose, this helps to get rid of pollen and other allergens.

Your doctor may also give you some steroid nose sprays. They help to lessen the swelling in the nose, nasal congestion, and post-nasal drip. It can take up to days and weeks before they work. They are only effective if you take them daily.

Your doctor may also give you some antihistamines and decongestants to help with itching, sneezing, and runny nose symptoms. We advise that you do not use the decongestants more than instructed by your doctor, as overuse will sometimes make your symptoms worse.

If required, your doctor may refer you to an Ear, Nose and Throat (ENT) specialist or offer you other treatments such as allergy shots or pills.

What can I do at home to feel better?

DOs

•      Rinse your nose 

•      Take medications as instructed to control your symptoms

DON'Ts

•      Avoid allergens that will make you feel worse (including cats or dogs)

•      Don't be around freshly cut grass or raked leaves

•      Don't smoke and avoid second hand smoke

How do I prevent allergic rhinitis?

If you get symptoms at the same time every year, talk with your doctor. Some people can prevent symptoms by starting their medications 1 to 2 weeks before that time of the year.

When can I return to work? When can my child return to school?

You can resume your normal activities once you feel better. It is important to know if the environment has allergens that will make you feel worse. If so, please avoid them and rest at home until you feel well.

When should I see my doctor again?

Please contact your doctor if you have: 

•      Fever

•      Ear or sinus pain, or a headache

•      Worsening symptoms even after treatment

•      Pain or bleeding from inside your nose 

•      Blood when you cough

Why get vaccinated?

Varicella (also called chickenpox) is a very contagious viral disease. It is caused by the varicella zoster virus. Chickenpox is usually mild, but it can be serious in infants under 12 months of age, adolescents, adults, pregnant women, and people with weakened immune systems. Chickenpox causes an itchy rash that usually lasts about a week. It can also cause:

•     Fever

•     Tiredness

•     Loss of appetite

•     Headache

More serious complications can include:

•     Skin infections

•     Infection of the lungs (pneumonia)

•     Inflammation of blood vessels

•     Swelling of the brain and/or spinal cord coverings (encephalitis or meningitis)

•     Blood stream, bone, or joint infections

Some people get so sick that they need to be hospitalized.It doesn’t happen often, but people can die from chickenpox. Some people who get chickenpox get a painful rash called shingles(also known as herpes zoster) years later. Chickenpox can spread easily from an infected person to anyone who has not had chickenpox and has not gotten chickenpox vaccine.

Chickenpox vaccine

2 doses: First dose at 12-18 months old, second dose at 4 years old.

Catch up vaccination:For 12 years old and below, 2 doses with 12 weeks interval, for 13 years old and above, 2 doses with 4 to 8 weeks interval. There are no known risks to getting chickenpox vaccine at the same time as other vaccines.

Some people should not get this vaccine 

Tell your vaccine provider if the person getting the vaccine:

•     Has any severe, life-threatening allergies. A person who has ever had a life-threatening allergic reaction after a dose of chickenpox vaccine, or has a severe allergy to any part of this vaccine, may be advised not to be vaccinated. Ask your health care provider if you want information about vaccine components

•     Is pregnant, or thinks she might be pregnant. Pregnant women should wait to get chickenpox vaccine until after they are no longer pregnant. Women should avoid getting pregnant for at least 3 months after getting chickenpox vaccine

•     Has a weakened immune system due to disease (such as cancer or HIV/AIDS) or medical treatments (such as radiation, immunotherapy, steroids, or chemotherapy)

•     Has a parent, brother, or sister with a history of immune system problems

•     Is taking salicylates (such as aspirin). People should avoid using salicylates for 6 weeks after getting varicella vaccine

•     Has recently had a blood transfusion or received other blood products. You might be advised to postpone chickenpox vaccination for 3 months or more

•     Has tuberculosis

•     Has gotten any other vaccines in the past 4 weeks. Live vaccines given too close together might not work as well

•     Is not feeling well. A mild illness, such as a cold, is usually not a reason to postpone a vaccination. Someone who is moderately or severely ill should probably wait. Your doctor can advise you

Risk of a vaccine reaction

With any medicine, including vaccines, there is a chance of reactions. These are usually mild and go away on their own, but serious reactions are also possible.

After vaccination, please stay in clinic observation area for 30 minutes.

Getting chickenpox vaccine is much safer than getting chickenpox disease. Most people who get chickenpox vaccine do not have any problems with it. After chickenpox vaccination, a person might experience:

Minor events

•     Sore arm from the injection

•     Fever

•     Redness or rash at the injection site

If these events happen, they usually begin within 2 weeks after the shot. They occur less often after the second dose.

More serious events following chickenpox vaccination are rare. They can include

•     Seizure (jerking or staring) often associated with fever

•     Infection of the lungs (pneumonia) or the brain and spinal cord coverings (meningitis)

•     Rash all over the body

A person who develops a rash after chickenpox vaccination might be able to spread the varicella vaccine virus to an unprotected person. Even though this happens very rarely, anyone who gets a rash should stay away from people with weakened immune systems and unvaccinated infants until the rash goes away. Talk with your health care provider to learn more.

Other things that could happen after this vaccine

•     People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your doctor if you feel dizzy or have vision changes or ringing in the ears

•     Some people get shoulder pain that can be more severe and longer-lasting than routine soreness that can follow injections. This happens very rarely

•     Any medication can cause a severe allergic reaction. Such reactions to a vaccine are estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination

As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

What if there is a serious reaction?

What should I look for?

Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination.

What should I do?

If you think it is a severe allergic reaction or other emergency that can't wait, call 120 or get the person to the nearest hospital. Otherwise, call your doctor.

Where can I get more information?

•     Jiahui Health

Contact number: 400-868-3000

•     Shanghai Municipal Center for Disease Control & Prevention 

Contact number: 021-62758710