Health Lifestyle

SunBurn

nyonyos — Thu, 30 Apr 2009 10:07:26 +0000

Sunlight can help our mental outlook and help us feel healthier. For people with arthritis, the sun’s warmth can help relieve some of their physical pain. Many people also think that a suntan makes a person look young and healthy. But sunlight can be harmful to the skin, causing immediate problems as well as problems that may develop years later.

A sunburn is skin damage from the sun’s ultraviolet (UV) rays. Most sunburns cause mild pain and redness but affect only the outer layer of skin (first-degree burn). The red skin might hurt when you touch it. These sunburns are mild and can usually be treated at home.

Skin that is red and painful and that swells up and blisters may mean that deep skin layers and nerve endings have been damaged (second-degree burn). This type of sunburn is usually more painful and takes longer to heal.

Other problems that can be present along with sunburn include:

Heatstroke or other heat-related illnesses from too much sun exposure.
Allergic reactions to sun exposure or to sunscreen products.
Vision problems, such as burning pain, decreased vision, or partial or complete vision loss.

Long-term problems include:

An increased chance of having skin cancer.
An increase in the number of cold sores.
An increase in problems related to a health condition, such as lupus.
Cataracts, from not protecting your eyes from direct or indirect sunlight over many years. Cataracts are one of the leading causes of blindness.
Skin changes, such as premature wrinkling or brown spots.

Your skin type affects how easily you become sunburned. People with fair or freckled skin, blond or red hair, and blue eyes usually sunburn easily. Your age also affects how your skin reacts to the sun. The skin of children younger than 6 and adults older than 60 is more sensitive to sunlight.

You may get a more severe sunburn depending on:

The time of day. You are more likely to get a sunburn between 10 in the morning and 4 in the afternoon, when the sun’s rays are the strongest. You might think the chance of getting a sunburn on cloudy days is less, but the sun’s damaging UV light can pass through clouds.
Whether you are near reflective surfaces, such as water, white sand, concrete, snow, and ice. All of these reflect the sun’s rays and can cause sunburns.
The season of the year. The position of the sun on summer days can cause a more severe sunburn.
Altitude. It is easy to get sunburned at higher altitudes, because there is less of the earth’s atmosphere to block the sunlight. UV exposure increases about 4% for every 1000 ft (305 m) gain in elevation.
How close you are to the equator (latitude). The closer you are to the equator, the more direct sunlight passes through the atmosphere. For example, the southern United States gets 1.5 times more sunlight than the northern United States.
The UV index of the day, which indicates the risk of getting a sunburn that day.

Preventive measures and home treatment are usually all that is needed to prevent or treat a sunburn.

Protect your skin from the sun.
Do not stay in the sun too long.
Use sunscreens, and wear clothing that covers your skin.

If you have any health risks that may increase the seriousness of sun exposure, you should avoid being in the sun from 10 in the morning to 4 in the afternoon.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

Emergencies

Do you have any of the following symptoms that require emergency treatment? Call 911 or other emergency services immediately.

Signs of shock occur:

In an adult.

In a child.

A severe allergic reaction occurs with difficulty breathing or swelling of the mouth or throat.

Signs of heatstroke occur, including:

Unconsciousness that lasts longer than 1 minute.

Convulsions (seizure).

Signs of moderate to severe difficulty breathing.

An elevated temperature after exposure to a hot environment.

Confusion, severe restlessness, or anxiety.

Rapid heartbeat.

Sweating that may be heavy or may have stopped.

Skin that may be red, hot, and dry, even in the armpits.

Severe vomiting and diarrhea.

Signs of severe dehydration occur after being in the sun too long:

In an adult.

In a child.

Note: After calling 911 or other emergency services, begin emergency first aid treatment if emergency medical personnel are not going to arrive soon.

Check Your Symptoms

If you answer yes to any of the following questions, click on the “Yes” in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

Note: If you have any of the following symptoms, evaluate those symptoms first.

Heat exhaustion: Go to the topic Heat-Related Illnesses.
Hives or other symptoms of an allergic reaction: Go to the topic Allergic Reaction.

Yes

Do your eyes hurt, or do you have new vision problems?

See significance of vision problems if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have severe pain in one or both of your eyes after being in the sun?

Yes

Have you had partial or complete vision loss or blurred vision for more than 30 minutes after getting out of the sun?

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Do you have moderate pain in your eye, such as a scratchy, gritty sensation?

Yes

Are your eyes sensitive when you look at light (photophobia)?

Yes

Have you had mild pain in your eyes for 24 hours or longer?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have a fever and other symptoms?

See significance of a fever if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you have symptoms of heat exhaustion, go to the topic Heat-Related Illnesses to evaluate your symptoms.
If you need information on how to take a temperature, see the topic Body Temperature.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have signs of moderate dehydration?

Yes

Do you have severe pain?

Yes

Do you have a severe headache?

Yes

Do you have severe fatigue?

Yes

Are you nauseated or vomiting and unable to drink any fluids?

Yes

Do you have a severe skin reaction or blisters?

Call your health professional today if you answer “Yes” to the following question.

Yes

Do you feel dizzy even after getting out of the sun?

You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer “Yes” to the following question.

Yes

Do you have a fever that has not come down after 24 hours of home treatment?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have symptoms of mild to moderate dehydration?

See significance of dehydration if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have symptoms of moderate dehydration and you are unable to drink enough to replace lost fluids?

Yes

Does your child have symptoms of moderate dehydration and he or she is unable to drink enough to replace lost fluids?

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Do you have symptoms of moderate dehydration but you are able to drink enough to replace lost fluids?

Yes

Does your child have symptoms of moderate dehydration but he or she is able to drink enough to replace lost fluids?

You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer “Yes” to any of the following questions.

Yes

Have you had symptoms of mild dehydration for 24 hours or longer?

Yes

Has your child had symptoms of mild dehydration for 24 hours or longer?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you think you have a skin infection?

See significance of a skin infection if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have diabetes?

Yes

Do you have a disease or take medicine that may cause problems with your immune system?

Yes

Do you have red streaks extending from the sunburned area?

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Do you have increased pain, swelling, redness, or warmth around the sunburned area?

Yes

Do you have any blisters draining pus?

Yes

Do you know or think you have a fever?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have pain from a sunburn?

See significance of pain if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you are evaluating your young child’s pain from a sunburn, see how to evaluate pain in a child age 3 or younger.

Call your health professional immediately if you answer “Yes” to the following question.

Yes

Do you have severe pain?

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Do you have moderate pain?

Yes

Does your child younger than 6 months of age have a sunburn and appear to be in pain?

You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer “Yes” to the following question.

Yes

Do you still have mild pain after using home treatment for 24 hours?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Are you taking a medicine that may cause you to sunburn easily?

See significance of medicine if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional today if you answer “Yes” to the following question.

Yes

Are you taking a medicine that may cause you to sunburn easily?

Note:

If your answer is Yes:

Call the doctor who prescribed the medicine before taking your next dose to determine whether you should stop taking the medicine or take a different one. An appointment may not be necessary.
If you are taking a medicine that was not prescribed by a doctor (nonprescription), stop taking the medicine. If you feel that you need to continue taking the medicine, call your doctor to discuss it.

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have blisters from a sunburn?

See significance of blisters from a sunburn if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Note:

See the topic Burns if you have skin blisters and think you may have a second-degree burn.

Call your health professional today if you answer “Yes” to the following question.

Yes

Are you worried about scarring?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have the following symptom?

Skin changes and a history of sunburns: Go to the topic Skin Changes.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home Treatment

Home treatment measures may provide some relief from a mild sunburn.

Use cool cloths on sunburned areas.
Take frequent cool showers or baths.
Apply soothing lotions that contain aloe vera to sunburned areas. Topical steroids (such as 1% hydrocortisone cream) may also help with sunburn pain and swelling. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to. Do not use in the rectal or vaginal area in children younger than age 12 unless your doctor tells you to.

A sunburn can cause a mild fever and a headache. Lie down in a cool, quiet room to relieve the headache. A headache may be caused by dehydration, so drinking fluids may help. For more information, see the topic Dehydration.

There is little you can do to stop skin from peeling after a sunburn—it is part of the healing process. Lotion may help relieve the itching.

Other home treatment measures, such as chamomile, may help relieve your sunburn symptoms.

**Medicine you can buy without a prescription**
Try a nonprescription medicine to help treat your fever or pain:
Acetaminophen, such as Tylenol or Panadol Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, such as Advil or Motrin Naproxen, such as Aleve or Naprosyn Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or Bufferin Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

**Safety tips**
Be sure to follow these safety tips when you use a nonprescription medicine:
Carefully read and follow all directions on the medicine bottle and box. Do not take more than the recommended dose. Do not take a medicine if you have had an allergic reaction to it in the past. If you have been told to avoid a medicine, call your doctor before you take it. If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to. Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Care of blisters

Home treatment may help decrease pain, prevent infection, and help the skin heal.

Small, unbroken blisters [less than 1 in. (2.5 cm) across] usually heal on their own.

Do not try to break the blisters. Just leave them alone.
Do not cover the blisters unless something such as clothing is rubbing against them. If you do cover them, apply a loose bandage. Secure the bandage so the tape does not touch the blisters. Do not wrap tape completely around a hand, arm, foot, or leg, because it could cut off the blood supply if the limb swells. If the tape is too tight, you may develop symptoms below the level of the tape, such as numbness, tingling, pain, or cool and pale or swollen skin.
Avoid wearing clothes or shoes or doing activities that rub or irritate the blisters until they have healed.

Large or broken blisters usually heal without problems. Most large blisters will break on their own and then heal.

Wash your hands with soap and water before touching blisters. Blisters can easily become infected.
If you have a large blister, you may want to drain it, depending on where it is. If you decide to drain it:
- Clean a needle with rubbing alcohol or soap and water, then use it to gently puncture the edge of the blister.
- Press the fluid in the blister toward the hole you made.
- Wash the blister after you have drained it, and pat it dry with clean gauze.
Do not remove the flap of skin covering the blister unless it tears or gets dirty or pus forms under it. If the blister has just a small puncture or break, leave the flap of skin on, and gently smooth it flat over the tender skin underneath.
Apply an antibiotic ointment, such as polymixin B or bacitracin, if you are not allergic to it. The ointment will prevent the bandage from sticking to the blister and may help prevent infection. Do not use alcohol or iodine on the blister, because these may delay healing. Do not use an ointment if you know you are allergic to it.
Loosely apply a bandage or gauze. Secure the bandage so the tape does not touch the blister. Do not wrap tape completely around a hand, arm, foot, or leg, because it could cut off the blood supply if the limb swells. If the tape is too tight, you may develop numbness, tingling, pain, or cool and pale or swollen skin below the level of the tape.
If the skin under the bandage begins to itch or develops a rash, stop using the antibiotic ointment.
Change the bandage every day and anytime it gets wet or dirty. You can soak the bandage in cool water just before removing it to make it less painful to take off.
Avoid wearing clothes or shoes or doing activities that rub or irritate the blisters until they have healed.

Watch for a skin infection while your blister is healing. Signs of infection include:

Increased pain, swelling, redness, or warmth around the blister.
Red streaks extending away from the blister.
Drainage of pus from the blister.
Swollen lymph nodes in your neck, armpit, or groin.
Fever.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

Vision problems continue after you get out of the sun.
Fever develops.
Nausea or vomiting starts or increases, and you are unable to drink enough to replace lost fluids.
Signs of skin infection in blisters develop.
Signs of an allergic reaction develop.
Symptoms become more severe or more frequent.

Prevention

Avoid sun exposure

The best way to prevent a sunburn is to avoid sun exposure.

Stay out of the midday sun (from 10 in the morning to 4 in the afternoon), which is the strongest sunlight. Find shade if you need to be outdoors. You can also calculate how much ultraviolet (UV) exposure you are getting by using the shadow rule: A shadow that is longer than you are means UV exposure is low; a shadow that is shorter than you are means the UV exposure is high.

Other ways to protect yourself from the sun include wearing protective clothing, such as:

Hats with wide 4 in. (10 cm) brims that cover your neck, ears, eyes, and scalp.
Sunglasses with UV protection.
Loose-fitting, tightly woven clothing that covers your arms and legs. Some outdoor stores may sell clothing treated with sun protection factor.

Do not use tanning booths to get a tan. Artificial tanning devices can cause skin damage and increase the risk of skin cancer.

Preventing sun exposure in children

You should start protecting your child from the sun when he or she is a baby. Because children spend a lot of time outdoors playing, they get most of their lifetime sun exposure in their first 18 years.

Keep babies younger than 6 months of age out of the sun. If sunscreen is needed, a small amount on the face or the back of the hands is not harmful.
Teach children the ABCs of how to protect their skin from getting sunburned.
- A = Away. Stay away from the sun in the middle of the day (from 10 in the morning to 4 in the afternoon).
- B = Block. Use a sunscreen with a sun protection factor (SPF) of 15 or higher to protect babies’ and children’s very sensitive skin.
- C = Cover up. Wear clothing that covers the skin, hats with wide brims, and sunglasses with UV protection. Even children 1 year old should wear sunglasses with UV protection.
- S = Speak out. Teach others to protect their skin from sun damage.

Sunscreen protection

If you can’t avoid being in the sun, use a sunscreen to help protect your skin while you are in the sun.

Use a sunscreen that has a sun protection factor (SPF) of at least 30 or higher. Sunscreens that say “broad-spectrum” can protect the skin from ultraviolet A and B (UVA and UVB) rays. Sunscreens come in lotions, gels, creams, and ointments.
Apply the sunscreen at least 30 minutes before going in the sun.
Apply sunscreen to all the skin that will be exposed to the sun, including the nose, ears, neck, scalp, and lips. Sunscreen needs to be applied evenly over the skin and in the amount recommended on the label. Most sunscreens are not completely effective, because they are not applied correctly. It usually takes about 1 fl oz (30 mL) to cover an adult’s body.
Apply sunscreen every 2 to 3 hours while in the sun and after swimming or sweating a lot. The SPF value decreases if a person sweats heavily or is in water, because water on the skin reduces the amount of protection the sunscreen provides. Sunscreen effectiveness is also affected by the wind, humidity, and altitude.
Use lip balm or cream that has sun protection factor (SPF) of 30 or higher to protect your lips from getting sunburned or developing cold sores.

Some sunscreens say they are water-resistant or waterproof and can protect for about 40 minutes in the sun if a person is doing a water activity. Apply sunscreen more often if you are in water. Wet skin can burn easily, so it is important to protect your skin even if you do not feel that you are getting sunburned. Wearing a T-shirt while swimming does not protect your skin unless sunscreen has also been applied to your skin under the T-shirt.

The following tips about sunscreen will help you use it more effectively:

Older adults should always use a sunscreen with an SPF of at least 30 to protect their very sensitive skin.
If you have sensitive skin that burns easily, use a sunscreen with an SPF of at least 30.
If you have dry skin, use a cream or lotion sunscreen.
If you have oily skin or you work in dusty or sandy conditions, use a gel, which dries on the skin without leaving a film.
If your skin is sensitive to skin products, use a sunscreen that is free of chemicals and alcohol.
If you have had a skin reaction (allergic reaction) to a sunscreen, look for one that is free of para-aminobenzoic acid (PABA), preservatives, and perfumes. These ingredients may cause skin reactions.
If you are going to be in very intense sunlight for a long period of time, consider using a physical sunscreen (sunblock), such as zinc oxide, which will stop all sunlight from reaching the skin.
If you need to use sunscreen and insect repellent with DEET, do not use a product that combines the two. You can apply sunscreen first and then apply the insect repellent with DEET, but the sunscreen needs to be reapplied every 2 hour

Burns

nyonyos — Thu, 30 Apr 2009 09:59:13 +0000

Most burns are minor injuries that occur at home or work. It is common to get a minor burn from hot water, a curling iron, or touching a hot stove. Home treatment is usually all that is needed for healing and to prevent other problems, such as infection.

There are many types of burns.

Heat burns (thermal burns) are caused by fire, steam, hot objects, or hot liquids. Scald burns with hot liquid are the most common burns to children and older adults.
Electrical burns are caused by contact with electrical sources or by lightning.
Chemical burns are caused by contact with household or industrial chemicals in a liquid, solid, or gas form. Natural foods such as chili peppers, which contain a substance irritating to the skin, can cause a burning sensation.
Radiation burns are caused by the sun, tanning booths, sunlamps, X-rays, or radiation therapy for cancer treatment.
Friction burns are caused by contact with any hard surface such as roads (“road rash”), carpets, or gym floor surfaces. They are usually both a scrape (abrasion) and a heat burn. Friction burns to the skin are seen in athletes who fall on floors, courts, or tracks. Motorcycle or bicycle riders who have road accidents while not wearing protective clothing might get friction burns. For information on treatment for friction burns, see the topic Scrapes.

Breathing in hot air or gases can cause injury your lungs (inhalation injuries). Breathing in toxic gases, such as carbon monoxide, can cause poisoning.

Burns injure the skin layers and can also injure other parts of the body, such as muscles, nerves, lungs, and eyes. Burns are defined as first-, second-, third-, or fourth-degree, depending on how many layers of skin and tissue are burned. The deeper the burn and the larger the burned area, the more serious the burn is.

First-degree burns are burns of the first layer of skin. See an illustration of a first-degree burn.
There are two types of second-degree burns:
- Superficial partial-thickness burns injure the first and second layers of skin. See an illustration of this type of second-degree burn.
- Deep partial-thickness burns injure deeper skin layers. See an illustration of this type of deep second-degree burn.
Third-degree burns (full-thickness burns) injure all the skin layers and tissue under the skin. See an illustration of a third-degree burn.
Fourth-degree burns extend through the skin to injure muscle, ligaments, tendons, nerves, blood vessels, and bones. These burns always require medical treatment.

The seriousness of a burn is determined by several factors, including:

The depth, size, cause, affected body area, age, and health of the burn victim.
Any other injuries that occurred, and the need for follow-up care.

Burns affect people of all ages, though some are at higher risk than others.

About 20% of burns occur in children younger than age 5, and most of these are scald burns from hot liquids.
About 60% of burns occur in the 18- to 64-year-old age group.
About 10% of burns occur in older adults, mostly scald burns from hot liquids.
Men are twice as likely to have burn injuries as women.

Burns in children

Babies and young children may have a more severe reaction from a burn than an adult. A burn in an adult may cause a minor loss of fluids from the body, but in a baby or young child, the same size and depth of a burn may cause a severe fluid loss.

A child’s age determines how safe his or her environment needs to be, as well as how much the child needs to be supervised. At each stage of a child’s life, look for burn hazards and use appropriate safety measures. Since most burns happen in the home, simple safety measures might prevent accidents and decrease the chance of anyone getting burned. See the Prevention section of this topic.

Most burns are accidental. When a child or vulnerable adult is burned, it is important to find out how the burn happened. If the reported cause of the burn does not match how the burn looks, abuse must be considered. Self-inflicted burns will require treatment as well as an evaluation of the person’s emotional health.

Infection is a concern with all burns. Watch for signs of infection during the healing process. Home treatment for a minor burn will reduce the risk of infection. Deep burns with open blisters are more likely to become infected and need medical treatment.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

Emergencies

Do you have any of the following symptoms that require emergency treatment? Call 911 or other emergency services immediately.

Breathing stops. After calling 911 or other emergency services, see the topic Dealing With Emergencies.

Signs of decreased level of consciousness develop, such as sleepiness (lethargy), confusion, extreme restlessness, or agitation.

Moderate to severe difficulty breathing from an airway burn or chemical fumes (smoke inhalation) develops:

In children.

In adults and older children.

Signs of shock develop:

In children.

In adults and older children.

Other serious injuries are present.

Burns extend through the skin to injure muscle and bones (fourth-degree burn).

Third-degree burns are present over more than 2% of the body.

Second-degree burns are present over:

More than 10% of the body of a person younger than age 10 or older than age 50.

More than 15% of the body of a person between ages 10 to 50.

Note: If a chemical has been swallowed that may be a poison or may cause burning in the throat and esophagus, call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) immediately for information on treatment. When you call the Poison Control Center, have the chemical container with you, so you can read the content label to the Poison Control staff member. The Poison Control Center can help determine what steps to take next.

Check Your Symptoms

If you answer yes to any of the following questions, click on the “Yes” in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

Chemical has been swallowed that may be a poison or causes burning in the mouth, throat, or the esophagus: call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) immediately for information on treatment. When you call the Poison Control Center, have the chemical container with you, so you can read the contents label to the Poison Control person. The Poison Control Center can help determine what steps to take next. You may find additional information in the Poisoning topic.
Chemical burn to the eyes: Go to the topic Burns to the Eye.
A friction burn: Go to the topic Scrapes.

Yes

Do you have breathing problems or throat problems after breathing in smoke (smoke inhalation)?

See significance of breathing problems or throat problems if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have mild difficulty breathing?

Yes

Do you have noisy breathing or wheezing?

Yes

Do you have a hoarse voice, difficulty speaking, or are you not able to speak in full sentences?

Yes

Do you have a lot of coughing?

Yes

Do you have dark-colored mucus from the nose or mouth?

Call your health professional today if you answer “Yes” to the following question.

Yes

Do you have normal breathing while at rest, but any amount of activity causes shortness of breath?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Have you had an electrical shock or been struck by lightning?

See significance of an electrical shock or burn if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to the following question.

Yes

Did lightning or electrical power cause a burn to the skin? Note: If you are not able to reach your health professional immediately, go directly to the nearest hospital emergency department.

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Has an electrical shock caused numbness and tingling but no injury to the skin?

Yes

Were you struck by lightning but you do not have any injuries?

Yes

Were you shot by a stun gun or Taser but you do not have any injuries?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have a chemical burn?

See significance of a chemical burn if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you are unable to reach your health professional immediately, call the local Poison Control Center or your National Poison Control Hotline (1-800-222-1222). When you call the Poison Control Center, have the chemical container with you, so you can read the content label to the Poison Control staff member. The Poison Control Center can help determine what steps to take next.

Call your health professional immediately if you answer “Yes” to the following question.

Yes

Do you have a chemical burn?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Does your child have a burn?

See significance of child’s burn if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your child’s symptoms.

Note:

The following questions will help you decide if and when your child needs to see a doctor based on the size of the burn. Be sure to answer all the questions to determine if your child needs to see a doctor because of other problems caused by a burn.
It can be hard to estimate the size of a burn. If you think a burn is a certain degree and size but you are unsure, it is best to discuss the degree and size of the burn with your health professional.
The “rule of palm” is one way to estimate the size of a burn. The palm of the person who is burned (not fingers or wrist area) is about 1% of the body. Use the person’s palm to measure the body surface area burned.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Does your child have a third-degree burn?

Yes

Does your child have a second-degree on his or her face, eyelids, ears, hands, feet, groin area, or over a joint?

Yes

Does your child have a second-degree burn covering from 1% to 10% of his or her body?

Call your health professional today if you answer “Yes” to the following question.

Yes

Does your child have a second-degree burn that is larger than a quarter?

Note:

Call your health professional today to determine if a visit is needed. Your health professional may not need to see you for your burn, but he or she will want to ask you questions to determine the seriousness of the burn and what steps you need to take next.

You need an appointment within the next 1 to 2 weeks if you answer “Yes” to the following question.

Yes

Is the healing scar from a burn pulling the skin tight or preventing normal movement of the area?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have a second- or third- degree burn?

See significance of a second- or third-degree burn if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

It can be hard to estimate the size of a burn. If you think a burn is a certain degree and size but you are unsure, it is best to discuss the degree and size of the burn with your doctor.
The “rule of palm” is one way to estimate the size of a burn. The palm of the person who is burned (not fingers or wrist area) is about 1% of the body. Use the person’s palm to measure the body surface area burned.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have a third-degree burn on less than 2% of your body?

Yes

Do you have a second-degree burn on your face, eyelids, or ears?

Yes

Are you older than age 50 and you have a second-degree burn covering from 1% to 10% of your body?

Yes

Are you younger than age 50 and you have a second-degree burn covering 2% to 15% of your body?

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Do you have a second-degree burn on your hands, feet, groin area, or over a joint?

Yes

Are you older than age 50 and you have a second-degree burn covering less than 1% of your body?

Yes

Are you younger than age 50 and you have a second-degree burn covering less than 2% of your body?

You need an appointment within the next 1 to 2 weeks if you answer “Yes” to the following question.

Yes

Is the healing scar from a burn pulling the skin tight or preventing normal movement of the area?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have a burn that goes completely around (encircles) your arm or leg?

See significance of a burn that encircles a limb if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to the following question.

Yes

Do you have a burn that goes completely around (encircles) your arm or leg?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you think a burn may have been caused by abuse?

See significance of a burn caused by abuse if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to the following question.

Yes

Do you think a burn may have been caused by abuse?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have continuing pain from a burn?

See significance of pain if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

See evaluating pain in children age 3 and younger if you are having difficulty determining your child’s level of pain.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have severe pain after using home treatment?

Yes

Do you have moderate pain that is getting worse after using home treatment?

Call your health professional today if you answer “Yes” to the following question.

Yes

Does pain prevent you from cleaning or treating the burn properly?

You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer “Yes” to the following question.

Yes

Have you had mild to moderate pain from a burn for longer than 24 hours after home treatment?

You need an appointment within the next 1 to 2 weeks if you answer “Yes” to the following question.

Yes

Is the healing scar from a burn pulling the skin tight or preventing normal movement of the area?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you think you have an infection?

See significance of an infection if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer “Yes” to any of the following questions.

Yes

Do you have diabetes?

Yes

Do you have peripheral arterial disease?

Yes

Do you have a disease or take a medicine that causes problems with your immune system?

Yes

Do you have red streaks extending from the burn?

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Do you have increased pain, swelling, redness, or warmth around the burn?

Yes

Do you have pus in or around the burn?

Yes

Do you know or think you have a fever?

You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer “Yes” to any of the following questions.

Yes

Have you had mild pain and swelling with redness less than 1 in. (2.5 cm) around a burn for 24 hours or longer?

Yes

Have you had swollen glands (lymph nodes) near a burn for 24 hours or longer?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you know or think you need a tetanus shot?

See significance of getting a tetanus shot if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you need a tetanus shot, call your doctor to arrange for the shot as soon as possible.

Your need for a tetanus shot depends on the seriousness of your wound and your tetanus shot history.
Your doctor may be able to tell you over the telephone if you need a tetanus shot.

Call your health professional today if you answer “Yes” to any of the following questions.

Yes

Are you worried that the burn has gotten dirty or has germs on it and your last tetanus shot was longer than 5 years ago?

Note:

Something is dirty if it has dirt, soil, spit, or feces on it.

Yes

Are you not sure when you had your last tetanus shot?

Yes

Did you not get the first series of tetanus shots?

If you have answered “No” to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following injuries that occurred with the burn?

Head injury: Go to the topic Head Injury, Age 4 and Older or Head Injury, Age 3 and Younger.
Cuts: Go to the topic Cuts.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home Treatment

Most minor burns will heal on their own, and home treatment is usually all that is needed to relieve your symptoms and promote healing. However, if you suspect you may have a more severe injury, use first-aid measures while you arrange for an evaluation by your health professional.

Immediate first aid for burns

First, stop the burning to prevent a more severe burn.
- Heat burns (thermal burns): Smother any flames by covering them with a blanket or water. If your clothing catches fire, do not run: stop, drop, and roll on the ground to smother the flames.
- Liquid scald burns (thermal burns): Run cool tap water over the burn for 10 to 20 minutes. Do not use ice.
- Electrical burns: After the person has been separated from the electrical source, check for breathing and a heartbeat. If the person is not breathing or does not have a heartbeat, begin rescue breathing and CPR. (See Dealing With Emergencies).
- Chemical burns: Natural foods such as chili peppers, which contain a substance irritating to the skin, can cause a burning sensation. When a chemical burn occurs, find out what chemical caused the burn. Call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) for more information about how to treat the burn.
- Tar or hot plastic burns: Immediately run cold water over the hot tar or hot plastic to cool the tar or plastic.
Next, look for other injuries. If you or the person who is burned was involved in an accident that caused the burn, other serious injuries may have occurred.
Remove any jewelry or clothing at the site of the burn. If clothing is stuck to the burn, do not remove it. Carefully cut around the stuck fabric to remove loose fabric. Remove all jewelry because it may be difficult to remove it later if swelling occurs.

Prepare for an evaluation by a health professional

If you are going to see your health professional soon:

Cover the burn with a clean, dry cloth to reduce the risk of infection.
Do not put any salve or medication on the burned area, so your health professional can properly assess your burn.
Do not put ice or butter on the burned area, because these measures do not help and can damage the skin tissue.

Home treatment for minor burns

For home treatment of first-degree burns and sunburns:
- Use cool cloths on burned areas.
- Take frequent cool showers or baths.
- Apply soothing lotions that contain aloe vera to burned areas to relieve pain and swelling. Applying 0.5% hydrocortisone cream to the burned area also may help. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to. Do not use in the rectal or vaginal area of children younger than age 12 unless your doctor tells you to.
There isn’t much you can do to stop skin from peeling after a sunburn—it is part of the healing process. Lotion may help relieve the itching.
Other home treatment measures, such as chamomile, may help relieve your sunburn symptoms.

For home treatment of second-degree burns, see home treatment for second-degree burns.

First-degree burns and minor second-degree burns can be painful. Try the following to help relieve your pain:

**Medicine you can buy without a prescription**
Try a nonprescription medicine to help treat your fever or pain:
Acetaminophen, such as Tylenol or Panadol Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, such as Advil or Motrin Naproxen, such as Aleve or Naprosyn Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or Bufferin

**Safety tips**
Be sure to follow these safety tips when you use a nonprescription medicine:
Carefully read and follow all directions on the medicine bottle and box. Do not take more than the recommended dose. Do not take a medicine if you have had an allergic reaction to it in the past. If you have been told to avoid a medicine, call your doctor before you take it. If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to. Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Lotions

Some health professionals suggest using skin lotions, such as Vaseline Intensive Care or Lubriderm, on first-degree burns or second-degree burns that have unbroken healing skin. These skin lotions can be used to relieve itching but should not be used if the burns have fluid weeping from them or have fresh scabs. An antihistamine, such as Benadryl or Chlor-Trimeton, can also help stop the itching. Read and follow any warning on the label.

When a first-degree burn or minor second-degree burn is 2 to 3 days old, using the juice from an aloe leaf can help the burn heal and feel better. Applying the aloe juice may sting at first contact.

It is important to protect a burn while it is healing.

Newly healed burns can be sensitive to temperature. Healing burns need to be protected from the cold, because the burned area is more likely to develop frostbite.
A newly burned area can sunburn easily. Sunscreen with a high sun protective factor (SPF at least 30) should be used for the first year after a burn to protect the new skin.

Do not smoke. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Tobacco Use.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

Pain, limited movement, or numbness develops.
Difficulty breathing develops.
Signs of infection develop.
Symptoms become more severe or frequent.

Prevention

Most burns happen in the home. Simple safety measures might prevent accidents in your home and decrease the chances of anyone getting burned.

Home safety measures

Do not smoke in bed.
Place smoke alarms and other fire safety devices in strategic locations in your home, such as in the kitchen and bedrooms and near fireplaces or stoves. Smoke detectors need to be checked and to have the batteries replaced regularly. A good way to remember to do this is to check smoke detectors twice a year when daylight savings and standard time change.
Make a fire escape plan, and make sure the family knows it (babysitters, too).
Keep a fire extinguisher near the kitchen and have it checked yearly. Learn how to use it. Put out food or grease fires in a pan with a lid or another pot.
Set your water heater at 120°F (50°C) or lower. Always test the temperature of bath water.
Store cleaning solutions and paints in containers in well-ventilated areas.
Use proper fuses in electrical boxes, do not overload outlets, and use insulated and grounded electrical cords.
Keep trash cleaned up in attics, basements, and garages.
Be careful with gas equipment such as lawn mowers, snow blowers, and chain saws.
Avoid fireworks. Think of safety first when dealing with fireworks.

Your local fire department is a good resource for more information on how to prevent fires, make a fire escape plan, use fire safety devices, and provide first-aid treatment for burns.

Child safety

Teach children safety rules for matches, fires, electrical outlets, electrical cords, stoves, and chemicals. Keep in mind child safety considerations. Prevention tips for children include the following:

Keep matches and flames, such as candles or lanterns, out of the reach of children. Keep small children away from stoves and ovens when you are cooking, and do not place pot handles where a child can reach them. Do not let children play with any small appliances such as curling irons, hair dryers, toasters, or heating pads.
Never hold a child while smoking or drinking a hot liquid, because any sudden movement by the child could cause an accident that causes a burn.
Never leave hot foods or liquids within reach of children, such as on the edges of tables or counters. Also, be cautious about leaving hot liquids on a table with a tablecloth that young children can reach and pull down.
Keep electrical cords away from a child’s reach. A child chewing on a cord could cause an electrical burn of the mouth. Cover electrical outlets so children will not stick items in the outlet.
Do not allow children to remove hot items from the oven or microwave. Use caution whenever heating baby bottles in the microwave so that the liquid does not get too hot. A liner may burst or a lid may not be secure, and when the bottle is tipped for feeding, the hot contents may burn the baby. For this reason, most health professionals recommend that bottles not be heated in the microwave.
Teach children who are old enough to understand to stop, drop, and roll if their clothing catches on fire so they can help put out the flame and prevent getting burned more.
Buy children’s sleepwear made of flame-retardant fabric. Dress children in flame- and fire-retardant clothing. Older adults need to be careful about wearing clothing with loose material that could catch on fire.
Keep wood stoves and fireplaces in good working condition, and use screens to keep children a safe distance away. Keep portable heaters, furnaces, water heaters, and small appliances in good working condition.
Store cleaning solutions and chemicals out of the reach of children.

Reduce the risk of a lightning strike

In general, avoid placing camping tents under tall trees, near bodies of water, or on the highest hill in an area. Seek shelter in a covered area, such as a car, if you get caught outdoors in bad weather. If no shelter is available, lie on the ground in a ditch or take cover in a thick grove of trees, where lightning striking a single tree is unlikely.

Avoid handling metal or electrical objects.
Avoid or stop using any machines outdoors.
Get out of water and off of boats.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

What caused the burn?
What kind of material was burning (such as wood, plastic, chemical, or asbestos)?
When did the burn occur?
What is the size and location of the burn? Can you estimate the depth as a first-, second-, or third-degree burn?
Was there a possibility of smoke inhalation? Was the fire in an enclosed place?
How was the fire put out?
Were there other injuries?
What home treatment has been used?
Do you have any health risks?

Lidocaine topical

nyonyos — Thu, 30 Apr 2009 09:55:49 +0000

What is the most important information I should know about lidocaine topical? An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops). Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin. Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of lidocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present. Keep both used and unused lidocaine topical patches out of the reach of children or pets. The amount of lidocaine in the skin patches could be harmful to a child or pet who accidentally sucks on or swallows the patch. Seek emergency medical attention if this happens. What is lidocaine topical? Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body. Lidocaine topical is used to reduce pain or discomfort caused by skin irritations such as sunburn, insect bites, poison ivy, poison oak, poison sumac, and minor cuts, scratches, hemorrhoids, and burns. Lidocaine topical is also used to treat sores inside the mouth, during dental procedures to numb the gums, and to numb the skin for a medical procedure (such as getting stiches). Lidocaine topical may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before using lidocaine topical? An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops). Do not use lidocaine topical if you are allergic to any other type of numbing medicine. Before using lidocaine topical, tell your doctor if you are allergic to any drugs, or if you have liver disease, or broken, swollen, or damaged skin. You may not be able to use lidocaine topical, or you may need dosage adjustments or special tests during treatment. FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Lidocaine topical can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use lidocaine topical? Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger or smaller amounts, or use it for longer than recommended. Lidocaine topical comes in many different forms for different uses. Lidocaine topical cream, lotion, spray, solution, film, and transdermal patch are generally for use on the skin only. Lidocaine topical gel, mucus membrane solution, and oral spray are for use in the mouth or on the gums. If your medication comes with patient instructions for safe and effective use, follow these directions carefully. Ask your doctor or pharmacist if you have any questions. Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin. Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of lidocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present. Do not apply this medication to swollen skin areas or deep puncture wounds. Avoid using the medicine on skin that is raw or blistered, such as a severe burn or abrasion. Lidocaine topical may be applied with your finger tips or a cotton swab. Follow your doctor’s instructions. Store lidocaine topical at room temperature away from moisture and heat. Keep both used and unused lidocaine topical patches out of the reach of children or pets. The amount of lidocaine in the skin patches could be harmful to a child or pet who accidentally sucks on or swallows the patch. Seek emergency medical attention if this happens. What happens if I miss a dose? Since lidocaine topical is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine. Lidocaine topical applied to the skin is not likely to cause an overdose unless you apply more than the recommended dose. Overdose may also occur if you apply heat, bandages, or plastic wrap to treated skin areas. Improper use of lidocaine topical may result in death. Overdose symptoms may include drowsiness, confusion, nervousness, ringing in your ears, blurred vision, feeling hot or cold, numbness, muscle twitches, uneven heartbeats, seizure (convulsions), slowed breathing, or respiratory failure (breathing stops), or coma. What should I avoid while using lidocaine topical? If you are using a lidocaine topical form meant only for use on the skin, do not allow the medicine to come into contact with your eyes. If it does, rinse with water. Avoid touching the sticky side of a lidocaine skin patch while applying it. Avoid using other topical medications on the affected area unless your doctor has told you to. What are the possible side effects of lidocaine topical? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using lidocaine topical and call your doctor at once if you have any of these serious side effects: uneven heartbeats; drowsiness, confusion; tremors, seizure (convulsions); or blurred vision. Less serious side effects include: mild irritation, redness, or swelling where the medication is applied; numbness in places where the medicine is accidentally applied. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect lidocaine topical? Before using lidocaine topical, tell your doctor if you are taking medication to treat a heart rhythm disorder, such as: quinidine (Quinidex, Quinaglute); disopyramide (Norpace); flecainide (Tambocor); mexiletine (Mexitil); procainamide (Procan, Pronestyl); tocainide (Tonocard); or propafenone (Rythmol). If you are using any of these drugs, you may not be able to use lidocaine topical, or you may need dosage adjustments or special tests during treatment. There may be other drugs not listed that can affect lidocaine topical. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Where can I get more information? Your pharmacist has information about lidocaine topical written for health professionals that you may read. ——————————————————————————– Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist