Emergency Action Steps
Below are various emergency medical protocols, checklists, questions, and MAMAs (Medical Acronym Memory Aids) – that I have found useful while caring for and teaching others. Some of what is below is well-known. Some I created myself.
Emergency Action Steps: [3CN2D]
[SAFETY/HAZARDS, ACCESS, EQUIPMENT, ASSISTANCE]
[Police, Fire, Ambulance, Coast Guard, Search & Rescue, Utility Company]
or Poison Control (CA: 1-800-8-POISON: age, weight, amount)
*Ensure you have CONSENT (Expressed, Implied, Parental) ~ Honor/Document Refusal of Care
If you are alone:
CALL FIRST when victim is unconscious and over 8 years of age
(or possible cardiac emergencies)
CALL FAST (after 1 minute of care) when victim is under 8 years of age
(or probable respiratory emergency)
and for victim(s) of submersion/drowning; arrest associated with trauma; drug overdose
Assessing Level of Consciousness (LOC): Responsiveness and Competence
If Conscious: “A/O times four”? (“A and O” = “Alert and Oriented” to I-LET)
1. Identity/Name: “What’s your (full) name?” or “Who are you?”
2. Location/Place: “Do you know where you are?” or “How’d you get here?”
3. Event/Others: “What happened?” or “Do you recognize anyone (else)?”
4. Time: “What/when do you remember last?” or “What time/day is it now?”
AVPU Response: Alert, Verbal, Pain, or Unresponsive
Glasgow Coma Scale: Eye Opening (1-4) + Verbal Response (1-5) + Motor Response (1-6)
Glascow Coma Scale: Eye Opening: 4 eyes; Verbal: Jackson 5; Motor: 6-cylinder engine
[Best GCS Score = 15, Worst = 3]
Especially if/when someone is Unconscious/Unresponsive:
Look for MedicAlert bracelet and/or other ID/med info
Perform Rapid Physical/Trauma Exam & reassess frequently
Check Pupils for size, shape, equality & reactivity (PEARL?)
Check for contact lenses, glasses, hearing aids, dentures, etc.
Estimate age, height, and weight (preferably in Kg)
Ask family/witness/bystanders for known info/medical history
If female, consider possibility/complications of pregnancy
Honor valid DNR/advance directives/DPAC decisions
If dead or dying, preserve body as possible organ donor
Consider possible AEIOU TIPS:
Alcohol or Allergies?
Epilepsy or Endocrine?
Infection?
Overdose?
Under-dose or Uremia?
Trauma or Temperature?
Insulin?
Psychological Disorder?
Stroke, Seizure, or Shock?
Assessment/Treatment/Response Priorities:
ABC/(D)
Airway
Breathing
Circulation
Defibrillate?
ABCHs
Airway open?
Breathing?
Circulation?
Hemorrhage?
spinal cord injury?
ABCDEFs
Airway & Cervical Spine
Breathing
Circulation / Bleeding (RED)
Disability (LOC, DOTS)
Expose & Examine
Freezing (Cold Injury)
shock / splint
RED (Blood)
Rest
Elevation
Direct Pressure
RED (Help)
Request
Encourage/Enlist
Demand
THREE ABC’s (ABC123)
A1: Assess scene/situation
A2: Airway (ensure patency)
A3: Alert Others (Call 9-1-1)
B1: Barriers (gloves, mask)
B2: Breathing (interventions)
B3: Bleeding (assess/control)
C1: CPR / AED?
C2: Cervical Spine / Collar?
C3: Cover, Protect / Carry?
Comfort, Calm, Reassure
Administer Oxygen (and/or appropriate fluids/meds) if trained and available
Attempt to contact/notify a child’s parent/guardian if not present
Make patient priority and transport decision(s)
Physical Examination and Documentation
CH2ECK (AFTER addressing any obvious Life Threatening Conditions (ABCs):
Chief Complaint: “What’s wrong?” or “Where do you hurt?”
(Assess Extent/Degree of Distress/Urgency)
History:
1. What caused injury or condition (MOI: Mechanism of Injury or NOI: Nature of Illness)
2. (SAMPLE) Information about allergies, medications, previous personal/family health problems
Exact Location: LAF / IAPP (estimate percentage of body surface area (BSA) burned/affected: Rule of Nines; Palm)
Compare: with other/uninjured side (and/or self) DOTS / DCAP-BTLS
Keep Checking: condition for change(s), CSM
(Stable: check each 15 minutes ~ Unstable: check in 5 minutes)
LAF:
Look for DOTS / DCAP-BTLS / Disease / Disability (and/or any missing body parts)
Ask about pain (OPQST); pregnancy (CCLUE) + months/due? pregnancy #? last delivery? pre-natal care?)
Feel for DOTS / DCAP-BTLS (note/differentiate any abdominal findings by quadrant/region)
IAPP:
Inspection
Auscultation
Palpation
Percussion
CSM:
Circulation
Sensation
Movement
DOTS:
Deformity
Open wounds
Tenderness
Swelling
DCAP-BTLS:
Deformities
Contusions
Abrasions
Punctures (or Penetration)
Burns
Tenderness
Lacerations
Swelling
CCLUE:
Contractions
Complications
Leaking
Urge (to push)
Expected Date
SOAP Notes:
Subjective (Symptoms/History)
Objective (Signs/Base Findings)
Assessment (MOI/NOI/Status)
Plan (Care/Treatment)
SAMPLE History:
Signs and Symptoms: “What seems to be the problem?”
Allergies: “Are you allergic to anything (that you know of)?”
Medications: “Are you taking anything (Rx, OTC, recreational)?”
Past History: “Has anything like this ever happened to you before?”
Last Meal/Oral Intake: “What/when did you last eat/drink?” “Hungry?” “Need to vomit (or void)?”
Events Leading up to Illness/Injury: “How did it happen?” “What led up to this?” “Anything else?”
PAIN:
“Describe the pain / discomfort for me?” “Where does it hurt?” “Point to where it hurts.”
OPQRST:
Onset/Origin: “When/how/where did it start?”
Provocative: “What makes it better/worse?”
Quality: “What does it feel like?”"Has it changed?”
Radiate/Region: “Do you feel it anywhere else?”
Severity: “How much does it hurt (Scale from 1-10)?”
Timing: “How often?” “Better/worse in AM or PM?”
ABCs of (Radio) Communication
Accuracy
Brevity
Clarity
First Responder/Ambulance RADIO Destination and Closest Facility Requests:
Age, Sex, Weight
C/C, Hx of events leading up to Cx
BRIM & OPQRST (expanding on them if needed)
V/S
Hx, Meds, ALG
Rx
Update pertinent V/S and changes following Rx
ETA
BSI: Body Substance Isolation
PCR: Patient Care Report
???
MCI: Mass/Multi-Casualty Incident Priorities:
Adults START: Resp Rate <10 or >30; Capillary Refill >2 seconds; GCS <13
Children JumpSTART: Resp Rate <15 or >45: No Distal/Peripheral Pulses; GCS <13
Simple Triage And Rapid Treatment (START)
0: Dead/Nonsalvageable – Black/Gray
I: Immediate – Red (Rabbit) – (P)U
II: Delay – Yellow (Turtle) – AV(P)
III: Minor – Green (No Ambulance)
Walking wounded = Minor
Immobile but able to follow instructions = Delayed
AVPU: AV(P) = DELAYED (P)U = IMMEDIATE
START where you stand: with “Walking Wounded” then RPM (Respiration ~> Perfusion ~> Mental Status)
Priority-1: Airway/respiratory/cardiac problem; uncontrolled hemorrhage; open chest/abdomen; severe head injury; shock; burn; medical
Priority-2: Spinal cord injury; multiple/major fractures; moderate burns; uncomplicated head injury
Priority-3: All minor/ uncomplicated fractures, wounds, other injuries, burns; psychological problems
RPM:
Respiration: over 30/min (or obstructed airway) = Immediate/Priority 1 [NO breathing = deceased]
Perfusion: absent radial pulse and capillary refill over 2 seconds = Immediate/Priority 1
Mental Status: Can’t follow simple commands = Immediate/Priority 1
0: Dead/Nonsalvageable – Not breathing (without assistance); [Children get 2 breaths]
I: Immediate – Difficulty with maintaining (adequate) breathing, circulation or thinking
II: Delay – Responsive/mentally aware but unable to move or improve (without support)
III: Minor – Able to walk, talk, (whine or wait) and help (care for themselves/others)
WNL: Within Normal Limits – or We Never Looked?
ADULT | CHILD | INFANT TPR “Norms”
Temperature (Oral/Rectal/Axillary/Tympanic;C/F) 97-99F (36.1-37.2C) [Rectal: +1F,Axillary: -1F]
Pulse (Location, Rate, Rhythm, Quality, Perfusion) 60-80BPM | 80-100BPM | 100-140BPM (at rest)
Respiration (Rate, Volume/Depth, Effort/Quality) 12-20RPM | 15 – 30RPM | 20 – 50RPM (at rest)
Blood Pressure (Systolic/Diastolic/Palpated) 100-140/60-90mmHg | 60-120/40-76mmHg (child)
*Skin (Color, Temperature, Moisture; Turgidity) Related TPR Changes: +/- 1F = +/- 10BPM = +/- 1-2RPM
“Average Adult” T: 98.6F/37C P: 70 R: 16 BP: 120/80 Minimum Palpable BP: 60 Carotid, 70 Femoral, 80 Radial
Pediatric Assessment Triangle:
Appearance: Alertness, Distractability, Consolability, Eye Contact, Speech/Cry, Spontaneous Motor Activity, Color
Breathing Effort: Audible Abnormal Breathing Sounds, Retractions, Nasal Flaring
Circulation to Skin: Skin Temperature, Pulse, Capillary Refill Time
Breath Sounds:
Stridor = Upper Airway Obstruction
Wheezing = Lower Airway Obstruction
Expiratory Grunting = Inadequate Oxygenation
Inspiratory Crackles = Fluid/Mucus/Blood in the Airway
Absent Breath Sounds = Complete Airway Obstruction, Pleural Fluid, Consolidation, or Pneumothorax
5 Ps of Circulatory Checks: Pain, Pallor, Paralysis, Paralysis, Pulse
7 Ps of Planning: Proper Prior Preparation Prevents Piss Poor Performance
The 7 Bs (Priorities for Managing Emergencies):
Breathing
Beating (Pulse, Pressure)
Bleeding
Brain
Bowel (Abdominal Injuries)
Bladder (Pelvic Injuries)
Bone
The 4 Bs of (Military) Logistics:
Beans
Bandages
Bullets
Badguys
Trauma Criteria:
Physiologic Factors
Anatomic Factors
Mechanisms of Injury
Additional Factors
Age and Co-Morbid Factors
“VITAL SIGNS”
LOC/Responsiveness (AVPU; Glascow Coma Scale: 4-5-6)
Pulse (Rate, Rhythm, Quality)
Respiration (Rate, Rhythm, Quality)
Blood Pressure (Systolic/Diastolic/Palpated; Pulse/Mean; Site/Location/Position)
Temperature (Oral, Rectal/Core, Axillary, Tympanic; Skin/Surface)(F, C)
+Pain/Discomfort (Level/Intensity, Location, Quality/Characteristics/Changes)
+Pulse Oxymetry (O2 SAT)
+End Tidal Capnography (ETCO2)
*Skin (Color/Appearance, Temperature/Texture, Moisture/Turgidity)
*Pupils (Size, Shape, Equality, Reactivity)
*Perfusion/Capillary Refill Time (+/- 2 seconds)
*(Peripheral) CSM (Circulation, Sensation, Movement)
Peripheral pulses should be compared for rate, rhythm, and quality.
Pulses are graded as:
0 Absent
+1 Weak and thready
+2 Normal
+3 Full
+4 Bounding
5 Ps of Vascular Insufficiency: Pain, Paralysis, Parasethesia, Pallor, Pulselessness
Questions to ask/factors to consider regarding Chief Complaint:
OPQRST:
Onset
Palliative/Provocative
Quality
Region/Radiation
Severity
Time
OLD CART:
Onset
Location
Duration
Characteristics
Aggravating Factors
Relieving Factors
Treatment
PASTMED:
Provocation
Associated Chest Pain
Sputum Production
Temperature
Medications
Exertion/Exercise Tolerance
Diagnosis (Previous)
Resulting from AEIOU TIPS?
Alcohol or Allergies
Epilepsy or Endocrine Problems
Infection
Overdose
Under-dose or Uremia
Trauma or Temperature
Insulin
Psychological disorder
Stroke, Seizure, or Shock
CC: Chief Complaint/Present Injury/Illness
PH: Personal/Past Medical History
FH: Family History
SH: Social History
Orthostatic/positional changes (BP & Pulse): Supine-Sitting-Standing (-Walking – Running)
Variance(s) when:
Asleep/Upon Waking/At Rest
Active/Under Stress
After Exercise/Exertion
Eating/Drinking/Voiding/Showering/Bathing
History of present illness
How do you feel?
What’s wrong?
Where does it hurt?
Since when?
When did your illness/pain begin?
How often?
How long does it last?
What makes it better/worse?
Has it happened before?
What have you eaten today?
What have you swallowed?
Have you thrown up?
Did you have an accident?
Where did it happen?
When did it happen?
What happened?
Past medical history
Have you ever had….?
What diseases have you had in your family/youth?
Have you ever had an operation?
Have you ever been hospitalized?
Are you taking any medications?
Are you allergic to any medicines?
Allergies/Anaphylaxis
Are you allergic to anything?
What are you allergic to?
What are your symptoms?
Are you allergic to penicillin/certain foods/insect stings?
Where you stung by a bee?
Have you inhaled anything unusual?
Have you ingested anything unusual?
Does your skin itch?
Do you have asthma?
Breathing Problems
Do you have…
a cold?
asthma?
chronic bronchitis?
a (dry) cough?
difficulty breathing (at night)?
emphysema?
expiration?
the flu?
heart disease?
heart failure?
phlegm?
pneumonia?
sore throat?
(pain or problem) with inspiration?
has this ever happened before?
Do take any medications?
Chest pain
Do you have chest pain?
Where does it hurt?
When did it start?
Does the pain radiate?
Have you ever had a heart attack (or stroke)?
History of heart problems?
Do you have…
palpitations?
a murmur?
shortness of breath?
hypertension?
Has this ever happened before?
Neurologic?/Neuralgic Disorders:
Do you have blurred vision?
convulsion
epilepsy
fainting spell
headache
hypertension
numbness
paralysis
stroke
tremors
Did you receive a blow to the head?
Move your arms/legs
What day is today?
Squeeze my fingers
Gastrointestinal/abdominal/genitourinary complaints
Does it hurt when I press here?
Has this ever happened before?
Do you have…
constipation?
diarrhea?
heartburn?
hemorrhoids?
indigestion?
stomach ache?
ulcers?
vomiting?
hepatitis?
jaundice?
nausea?
regular bowels?
dysuria?
gallstones?
blood in the urine?
venereal disease?
syphilis?
gonorrhea?
Burns:
Body Surface Area (BSA)
Stop further burning
Drop temperature
Roll protective covering around site
Earthquakes: Seek/Create “Triangle of Life”
Do NOT “duck & cover” or hide under anything; lie next to it!
Burning stopped
Breathing maintained
Body examined
Cool
Cover
Carry
Physical Examination / Injury Evaluation:
HOPS:
History
Observation
Physical Exam/Palpation
Special Tests
FACTS:
Function
Arterial pulse
Capillary Refill
Temperature – skin
Sensation
(Newborn) APGAR:
Appearance (color)
Pulse (heart rate)
Grimmace (reflex, irritability)
Activity (muscle tone)
Respiratory (effort)
ASC LAST: let patient talk first, then ask specific questions
Aggravating and Alleviating Factors
Severity
Character, Quality
Location
Associated Symptoms
Setting
Timing
VARIATIONS WHEN:
Adult
Male
Female
Child
Infant
Upon Awaking
Asleep/At Rest
Under Stress
After Exercise/Exertion
Sitting / Supported
Standing / Walking / Running
Laying Down
Eating/Drinking/Voiding/Showering/Bathing
various animals?
Blood Vessels
Checking Pulse / Circulatory Pressure Points
Controlling Bleeding (Internal & External)
Bones & Joints (Ligaments)
Movement
Reducing Dislocations
Setting Breaks (Traction), Splinting & Wrapping
Muscles & Tendons (Origins & Insertions)
Movements, Posture, Balance
Testing (Strength, Function, Range of Motion)
Stretching
Strengthening
Organs
Medicine
Food
Herbs & Flowers
Homeopathic Remedies
Pharmaceuticals
Intake/Administration:
Oral (Tablet, Capsule, Liquid, Inhalant)
Topical (Liquid, Cream, Gel, Aerosol)
Intradermal/Subcutaneous (ID), Intramuscular (IM), Intravenous (IV), Intraoseos (IO)
Human Reflexology:
Body
Face
Eye (Pupil, Sclera)
Ear
Tongue
Hand
Feet
Wound Closure
Butterfly Bandages, Steristrips, Coverslip Enclosures, Duct Tape
Sutures, Needle & Thread
New Skin, Crazy Glue
Suctioning
Electric
Manual
Syringe
Bulb (Turkey Baster)
Tube (Hose, Straw)
Supplemental Oxygen
blood pressure:
the bladder of BP cuff must be equal to at least 80% of the circumference of patients arm.
hypertension:
vascular diseases (artherosclerosis)
kidney disease
sodium retention
metabolic disturbances
blood clots
stroke
myocardial infarction/heart attack
ruptured aneurysm
hemorrhage
hypotension:
decreased circulation in blood volume (bleeding/hemorrhage)
change in diameter of blood vessels (neurogenic shock)
cardiac tamponade
head trauma/brain injury
shock
cardiac failure
toxins/poison in the blood
Vital Sign Reassessment:
At least every 15 minutes in a stable patient
At least every 5 minutes in an unstable patient
After every significant intervention you provide
When requested by advanced life support personnel
Inadequate ventilation (air hunger):
retractions
nasal flaring
irregular rhythm
unequal or inadequate chest expansion
shallow tidal volume (shallow breathing)
abnormal, diminished or absent breath sounds
pale, cool, and clammy skin
hypoxia/cyanosis
Assisted Artificial Ventilation:
Inadequate tidal volume
Respiration rate that is too slow or too fast
Signs of respiratory compromise
An altered level of consciousness
“VITAL SIGNS” ADULT-CHILD-INFANT “Norms”
Temperature (Oral? Rectal? Axillary? Tympanic?) 97-99F (36.1-37.2C) [R:+1F, A:-1F]
Pulse (Rate, Rhythm, Quality) 60-80BPM 80-100BPM 100-140BPM
Respiration (Rate, Rhythm, Depth) 12-20RPM 15-30RPM 20-50RPM
Blood Pressure (Systolic/Diastolic) 100-140/60-90mmHg 60-120/40-76mmHg
*Skin (Color, Temperature, Moisture) Average T: 98.6F P: 70 R: 16 BP: 120/80
*Pupils, *Pain, *Capillary Refill, *Turgidity
Four Disease processes:
Traumatic (Injury)
Infections
Metabolic
Psychological
Pathogens: Viruses, Bacteria, Fungi, Protozoa, Rickettsia
Pathogen, Quantity, Susceptibility, Entry Site
Direct Contact, Indirect Contact, Airborne, Vector-borne
Grief/Loss/Stress Emotions:
ADABDA:
Anxiety
Denial
Anger
Bargaining
Depression
Acceptance
7 Stages:
Confusion
Denial
Anger-Guilt
Hope
Depression
Acceptance
Understanding
6 Ds / Warning Signs
Defensiveness
Depression
Disorganization
Defiance
Dependency
Decision-Making Difficulties
Soft Tissue Injuries
Open Soft Tissue Injuries:
abrasions, lacerations, avulsions, pentrations/puncture wounds, amputations, crush injuries
Closed Soft Tissue Injuries:
contusions (bruises), hematomas, crush injuries
Bruises:
Phases of Bruise Discoloration:
Color Age
Red = 1-2 days
Purple/Blue = 2-5 days
Green = 5-7 days
Yellow = 7-10 days
Brown = 10-14 days
Stop the Burning
Drop the Temperature
Cover with Protective Bandaging
Muscle and Bone Injuries
Mechanical Injuries: Direct, Indirect, Twisting, Contracting
Fracture, Dislocation, Sprain, Strain,
dislocation, subluxation
grade 1,2,3 sprain (ligament)/strain (muscle/tendon)
muscle cramps, muscle guarding, muscle soreness,
contusions (bruises), nerve injuries
tendonitis, tenosynovitis, bursitis, osteoarthritis
myofascial trigger points
Healing process: inflammatory response, fibroblastic repair, maturation remodeling
Acute injuries = Trauma
Chronic injuries = Overuse
long bones: diaphysis, epiphysis, articular cartilage, periosteum
osteoblasts (bone-forming cells), callus, oestoclasts
Fractures: closed/simple, open/compound; comminuted/shattered
Comminuted fractures
Depressed fractures
Greenstick fractures
Impacted fractures
Longitudinal fractures
Oblique fractures
Serrated fractures
Spiral fractures
Transverse fractures
Contrecoup fractures
Avulsion fractures
Blow-out fractures
stressors: tension, compression, bending, twisting (torsion), shear
mechanisms/pattern:
bending => transverse
torsion => spiral
compression plus bending/oblique => transverse
compression plus bending plus torsion => oblique
variable => comminuted
compression => metaphyseal compression
Seizure Classifications:
Partial Seizures: 60%
Simple partial seizure
Complex partial seizure
Partial seizures with secondary generalization
Generalized Seizures: 30%
Absence seizures (petit mal)
Tonic-clonic seizures (grand mal)
Tonic seizures (rigidity)
Clonic seizures (rhythmic jerking)
Atonic seizures
Febrile seizures
Unclassified Seizures: 10%
Neonatal seizures
Infantile spasms
Epilepsy
Idiopathic
Epilepogenic
Prodrome, Premonitory, Aura (associated with partial seizures)
Clonus
Flaccidity
Conjugate gaze
Syncope
Primary motor cortex
Primary sensory cortex
autonomic function, visual cortex, auditory, olfactory
Frontal lobe, Temporal lobe
Postictal
Expressive Aphasia
Receptive Aphasia
Benzodiazepines:
Diazapam (IV)
Lorazepam (IV)
Midazolam (IM)
Medical and Behavioral Emergencies:
Diabetes:
Type I
Type II
Syndrome X
Diabetic Emergencies:
Hypoglycemia
Hyperglycemia
Behavioral Emergencies:
Stroke:
Frostbite:
Medical and Behavioral Emergencies:
Organophosphate Poisoning (SLUDGE):
Salivation
Lacrimation (Excessive Tearing)
Urination
Diaphoresis
Gastrointestinal Motility
Emesis
Drugs:
Stimulants, Hallucinogens, Depressants, Narcotics, Inhalants, Cannabis Products, Other
“420″ = Marijuana
Temperature, Climate & Environment:
Altitude Sickness:
HACE: High Altitude Cerebral Edema
HAPE: High Altitude Pulmonary Edema
(Nitrogen Narcosis)
(Bends)
Hyperthermia:
Miliaria / Prickly Heat
Sun glare (UV A, B, C)
Heat Cramps
Heat Fatigue / Heat Exhaustion
Heatstroke / Sunstroke
Hypothermia:
Immersion Foot / Trench Foot
Frost Nip
Frost Bite
Snow Blindness
Temperature Extremes:
Heat:
Al-Aziziyah, Libya (Africa) 57.7C (136F)
Death Valley, California (North America) 56.7C (134F)
Tirat Zevi, Israel (Asia) 53.9C (129F)
Cloncurry, Queensland (Australia) 53.1C (127.5F)
Seville, Spain (Europe) 50C (122F)
Rivadavia, Argentina (South America) 48.9C (120F)
Luzon, Philippines (Pacific Islands) 40.5C (105F)
Cold:
Vostok (Antartica) -89.2C (-128.6F)
Oymyakon, Russia (Asia) -67.7C (-89.9F)
Snag, Yukon (North America) -62.8 (-81F)
Ust-Shchuger, Russia (Europe) -55C (-67F)
Colonia, Argentina (South America) -33C (-27F)
Ifrane, Morrocco (Africa) -23.9C (-11F)
World’s Most Venemous Land Snakes by Region:
Europe: Adder
North & South America: Rattlesnakes
Copperhead
Fer de Lance
Cottonmouth
Bushmaster
Coral snake
Africa & Asia: Cobras
Kraits
Boomslang
Mambas
Russell’s Viper
Puff Adder
Saw-Scaled Viper
Malay Pit Viper
Australasia: Death Adder
Australian Black Snake
Taipan
Tiger Snake
Australian Brown Snake
Poisonous Sea Creatures
Poisonous Spines:
Stingrays
Sea Urchins
Neatocysts:
Jellyfish
Anemones
Octopi
Bites:
Sea Snakes
Insects
Bees
Mosquitos
Ants
Spiders
Ticks
Leeches
Internal Parasites
Roundworm
Hookworm
Threadworm
Tapeworm
Amoeba
Blood Flukes
Appendicitis / Peritonitis
Cholera
Diarrhea
Haemorrhoids (Piles)
Hepatitis (A,B,C,D,G)
Hernia
Malaria / Dengue
Cramp
Poliomyelitis
Meningitis
Rabies
Swollen Feet
Tuberculosis
Typhoid
Typhus
Urinary Tract Infection
Vaginal Disorders
Yellow Fever
