Patient information

This leaflet will provide information to help you recover from your ankle injury.

When you go over on or twist your ankle you can damage the ligaments and tendons that support and move the ankle joint. This type of injury can cause pain, swelling and bruising more commonly on the outside of the ankle. Your ankle will also feel limited in its movement and you may have difficulty walking and have a limp.

These symptoms are expected after this type of injury. Your injury will heal, but it is important to do the correct treatment yourself to reduce the pain and swelling, and improve the movement.

Pain

If you feel the pain is severe enough to stop you sleeping then take some regular pain relief. Paracetamol taken regularly will help control the pain and allow you to exercise more comfortably. If you need a stronger painkiller such as Codeine then see your GP.

As the inflammation process of the injury needs to happen it is important that you don’t take Ibuprofen for the first 48 hours. If the swelling persists after this time then you can take Ibuprofen as well as the Paracetamol. If you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets. (Ibuprofen is not recommended if you have asthma, kidney disease or stomach problems)

Swelling

This usually occurs soon after the injury, but bruising may appear later on.

It is important to limit the amount of swelling you have as too much can delay the healing.

As soon as you get home you need to sit with your ankle supported on a few pillows. Your ankle has to be higher than your knee for gravity to help get rid of the swelling. If possible you need to rest in this position for at least the first 24-48 hours after the injury. If the swelling continues after this time you need to spend as much of the day as possible in this elevated position as you can.

Ice packs

Using a proper ice pack on the ankle every two hours will also help both the pain and the swelling. Ideally use a large pack of frozen peas and wrap this in a tea towel that is wet with cold water (do not put the packet plastic in contact with your skin and do not leave on while you are asleep).

Place this pack over the worst area of the ankle and press it on firmly. Wrap this in place tightly with a bandage, scarf or another towel. Keep this ice pack in place for 15-20 minutes. Immediately after do some gentle exercises as shown below.

Remember to put the peas back in the freezer so you can use them again but remember to label them clearly so you don’t cook them by mistake. Repeat the icepack treatment every two hours.

Walking

You may find this difficult to start with due to the pain and stiffness so you will need to rest. If you have been given crutches use these initially for the first 1-2 days until the pain and swelling is easier and you can put your foot to the floor. Try to walk with a normal walking pattern as soon as possible – heel to the floor first, and then push off with your toes with the foot pointing forwards rather than sideways. Gradually build up the amount of walking you do over the next week, both in distance and speed, without overdoing it in the early stages. If you get a recurrence of the swelling after walking remember to sit with your ankle elevated and try some more icepacks.

Ankle exercises

It is generally advised not to immobilise injured joints, but to start gentle exercises as soon as possible – taking adequate pain relief and using regular ice packs should allow you to feel more comfortable to exercise

In a lying position try to bend your ankle up to you and then push away Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In a lying position try to turn your big toe into the middle and then turn your little toe to the outside Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
Stand in a walking position with the leg to be stretched straight out in front of you. Take support from a wall or chair Lean your body forwards and down until you feel the stretch in the calf of the leg out behind you. Hold for 30 seconds then relax Repeat three times at least 3-4 times a day
Once the ankle feels more comfortable: In a standing position raise up on your toes so your heels lift off the floor Try this 10 times at least 3-4 times a day. You may find that this is easier to do a few more days after the injury. Once the pain and swelling have settled see if you can do this on your injured ankle only whilst holding on.
Try balancing on just your injured leg. Start with holding on if you need to and with your eyes open. Gradually increase the time you can balance unsupported

Getting back to activity 

Depending on the severity of the sprain, you should be walking within 1-2 weeks, but full healing of the damaged tissues can take at least six weeks.

Activities such as swimming, cycling and controlled walking can help to maintain your general fitness whilst the ankle mends.

Make sure that you have regained full movements of the ankle, that all the pain has settled and you can walk normally and quickly before you try running again.

After 6-8 weeks you can start back to some light training or gym work and test your ankle out with specific sport exercises before playing competitively again.

Try to prevent further sprains by warming up before exercise, take precautions against falling and taking care when walking or running on uneven surfaces)

First Aid:  If you have been bitten by an animal, or have suffered a human bite, it is important the wound is cleaned thoroughly with large volumes of clean drinkable water or antiseptic.  All human and animal bites can easily become infected.

Treatment:

·         All minor bites and scratches will be cleaned thoroughly with potable (drinkable) water or sterile salt water

·         A deep wound will not be stitched due to the risk of infection

·         Paper stitches (steristrips) may be applied to the wound to help the skin close

·         An antiseptic dressing will be usually be applied to the wound

If your injury affects your arm you may be required to wear a high sling to help prevent swelling.

Bites to the face may need suturing immediately or in a few days after infection settles.

Human bites:

• You may be required to have a blood sample taken
• You may be given an anti-tetanus or hepatitis B vaccine depending on your immunity status.
• A full course of antibiotics will be prescribed for all bites, human and animal.

Go to your nearest emergency department or walk in centre at once if:

• Increasing redness or swelling develops around or leading from the bite
• The area becomes more painful
• You develop a raised temperature or feverishness  

This leaflet will provide you information to help you recover from your Back Pain.

The bones of the spine link together to form joints on each side, from your neck to your lower back. Each bone of the spine is called a vertebra and between each bone is a disc, which acts like a shock absorber. When you injure your back you can strain the ligaments and tendons that support and move the joints of the spine. Your back will feel limited in its movement and you may have difficulty walking.

These symptoms are expected after this type of injury. It will recover, but it is important to do the correct treatment to reduce the pain and improve the movement.

How to deal with Acute Back Pain:

• Be sensible – Your back pain should start to settle within a couple of days if you can avoid further strain.
• Modify Activity – Stay as active as possible. Your back is designed for movement and too much rest will allow the soft tissues and joints to stiffen up and cause more pain.
• Vary your position – Do not stay in the same position for long periods of time. Avoid long rests in bed and sitting. DO NOT sit unless your back is properly supported.
• Maintain Posture – Aim to keep the spine as straight as possible at all times. Avoid: bending, twisting, slouching and lifting.
• Experiment – Trying to find the most comfortable position for your back will take time. Some suggestions are: lying face down with a pillow under your stomach, side lying with a pillow to support your upper arm and one in between the knees. Avoid prolonged sitting or lying on your back.
• Lifting – Try to avoid lifting at all costs. If you do need to lift, make sure your technique is good with a straight back, knees bent, holding the object close to the body and not twisting.
• Control Pain - If you feel the pain is severe enough to stop you sleeping then take some regular pain relief. Normal paracetamol taken regularly will help control the pain and allow you to exercise more comfortably.

You may add Ibuprofen (400mg) three times each day, after food, as well as the paracetamol. If you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets.

If you take Co-codamol from the Chemist it is a combination of Codeine Phosphate (8mg) and Paracetamol (500mg). This can be taken with the Ibuprofen, but not with Paracetamol as well.

If your Doctor has prescribed pain killers, make sure that you take them regularly as instructed.

Heat packs - Using a heat pack on the back will also help the pain and ease any muscle spasm. To protect the skin, wrap the pack in a towel and this will prevent any burns to the skin. Place the pack over the worst area of pain, whilst lying in a comfortable position. Immediately after do some gentle exercises as shown below.

You can repeat the heat treatment every two hours if necessary.

If you do not have a Heat Pack, a hot shower in standing, is better than lying awkwardly in the bath. You may struggle to get out of the bath.

• Walking -You may find this difficult to start with due to the pain and stiffness. Try to walk with a normal walking pattern as soon as possible, it is important to maintain an upright and level posture to protect the joints of the spine. Gradually build up the amount of walking you do over the next week, both in distance and speed without overdoing it in the early stages.
• Progress – If you are improving, aim to gradually increase activities until you get back to a normal lifestyle. This may take a few weeks and needs patience.
• Think – Whether at home or at work, the speed at which your back will recover depends on how much strain you put onto the back. Think and plan before you perform a task.
• Stay Positive – your back is more likely to recover without future problems if you consider the advice in this leaflet.

Try to avoid……..

· Bending over work surfaces for prolonged periods of time.

· Lifting

· Prolonged sitting

Back exercises:

Please try these exercises on a regular basis – it is important to regain your movement as soon as possible.

Lay face down, arms beside your body, head to one side. Take a few deep breaths then try to relax the muscles in you back hips and legs for 3 minutes. Try this 3-4 times a day. Lay over 1 or 2 pillows if more comfortable
Remain laying face down. Place your elbows under your shoulders with your arms out in front. Take a few deep breaths and try to relax the muscles in your back, hips and legs for 3 minutes. Try this 3-4 times a day. This should feel like a stretch in the lower back – but not increase your back or leg pain.
Remain laying face down. Place your hands under your shoulders in the press up position. Straighten your elbows and push the top half of your body up as far as the pain permits. Maintain this position for 2 seconds then return to the starting position. Repeat this exercise 10 times. Try this 3-4 times a day
In a standing position place both hands into the small of your back for support. Arch backwards to stretch the lower back. This exercise can be used, at work as a substitute for the first exercise, if you are unable to lie onto the floor. Repeat 10 times for 3-4 times a day. You may find that this is easier to do a few more days after the injury.
In a standing position reach down the outside of your left leg towards the knee crease bending your back sideways Repeat 10 times 3-4 times a day. Repeat this to the left side – you are aiming to reach equally to the left and right.

If you are still struggling, see your GP for further management and a referral to physiotherapy

If you have a superficial burn on your body, arms or legs we may have taken the dead skin off any blisters and dressed with a special dressing to help heal the wound.  It may take up to a couple of weeks to heal properly.

You should: 

• Keep the burn and dressing clean and dry
• Take paracetamol or ibuprofen to help relieve the pain

You should not: 

• Take the dressing off

GO TO YOUR GP OR NEAREST EMERGENCY DEPARTMENT OR WALK-IN CENTRE AT ONCE IF:

• Any fluid comes from the burn
• You accidentally get the dressing wet
• Your burns start to feel worse
• You feel ill or develop a high temperature

FOLLOW-UP CARE:

• Please make arrangements to see your practice nurse/GP to check/redress the wound
• You will need to attend the hospital burns clinic (Central Treatment Suite) for wound care

Your chest injury may be very painful for several weeks, but you must try to breathe deeply so that you fill your lungs with air at least once or twice a day.  This decreases your chances of getting pneumonia.

You should

• Keep moving around your home.
• Take tablets such as paracetamol or ibuprofen (both available from a chemist) to relieve the pain
• Take a few deep breaths at least once a day
• Cough if you need to.  Press firmly on the sore part of your chest if coughing hurts.

You should not:

• Lift things
• Stay in bed
• Smoke
• Strap or bind your ribs,  this can be harmful as it prevents deep breathing.

 Go to your nearest emergency department or walk in centre at once if:

·        You suddenly feel breathless during normal activity.

·        You cough up any blood

Conjunctivitis is an inflammation of the clear surface of the eye or conjunctiva. It usually starts in one eye but can spread to both.  It can be caused by:

1. Bacterial infection in the eye
2. Viral infection e.g. flu like virus
3. Allergy e.g. due to pollen, house dust or pets.

You may experience all or some of these symptoms:- Redness, watering/discharge, gritty feeling/slight feeling of something in the eye,  sometimes slight sensitivity to light, puffiness or swelling of the eye/itching.

Treatment:  this will depend on the cause or type:

1. Bacterial type - treated with antibiotic drops and/or ointment (always complete the full course of antibiotics or the infection can return)
2. Viral type - an antibiotic may be prescribed but despite the treatment little or no improvement is likely to occur for 2 weeks.  This is because all viruses have to run their course before resolving.
3. Allergic type – may involve the use of anti-allergic drops.  If you know what has caused the allergy you should avoid contact with it if possible.

Conjunctivitis caused by virus or infection can be passed on from one person to another very easily by touch.  It is important to follow these instructions:

1. Follow the instructions on your drops/ointment and complete the course of the treatment.
2. Do not let anyone else use your drops/ointment.
3. Keep a separate towel, flannel and soap for your own use.
4. Wash hands at regular intervals to avoid spreading the infection to others.
5. Children should be discouraged from rubbing or touching their eyes if possible.
6. Contact lens wearer should stop wearing their lenses.  The lenses can be worn when all symptoms have resolved.  It is essential that you thoroughly clean/sterilise lenses during use strictly following the manufacturer’s instructions

Conjunctivitis can be treated by your GP or Walk-in-Centre.  If it does recur in the future he/she can help you.

What is it?

This is a scratch on the cornea (window) of your eye, often caused by a poked finger or perhaps a twig

Symptoms and signs

• Watering of the eyes
• Pain Corneal abrasion
• Redness of the white part of the eye
• Feeling of something in the eye
• Blurring of vision if the scratch is over the pupil (black part of the eye)

The cornea is the most sensitive part of the eye. We will look at your eye using a slit lamp which is like a large microscope. We use a coloured eye drop (Fluorescein) to enable us to see the size and depth of the scratch

How is it treated? 

• Usually you will only need to use antibiotic ointment for a few days to prevent infection and lubricate the eye while the scratch heals
• For deeper scratches it is sometimes helpful to firmly pad the eye closed for 24-48 hours. This stops you blinking and lets the scratch heal

A corneal abrasion can be very painful

To help relieve this:

·         We may prescribe a dilating drop to be instilled. This will make the pupil bigger. As it relaxes the muscles in your eye it settles the pain but for a few days your eye may be more sensitive to light and your vision may be blurred, especially for close work

·         Take a pain killing tablet as you would for a headache, e.g. Paracetamol or Ibuprofen (NB follow the directions for dosage)

What happens next?

Corneal abrasions will often heal within 24-36 hours. Occasionally we may ask for an appointment to be made at the Emergency Eye Clinic before leaving the department. In some instances the problem may recur. This will be particularly noticeable on waking.

If you have any further problems within the next few days please contact:

9.00am – 5.00pm          Emergency Eye Clinic             01782 674300

Out of hours                Emergency Department           01782 674440 or 674470

A corneal foreign body is a particle which has become stuck to the front of the eye. Usually you feel that something has flown or blown into your eye. You may have been grinding, cutting or drilling 1-3 days earlier.  The small particle, which we call a ‘foreign body’, often lies on the cornea (window) part of the eye.  The most common foreign body is a rusty metal particle. The foreign body may cause:

• Watering of the eyes
• Painful uncomfortable feeling that something is in your eye.
• Redness of the white part of the eye
• Sensitivity to light
• Sometimes blurred vision

The cornea is the most sensitive part of the eye.

How is it removed? 

• Anaesthetic (numbing) drops are instilled into the eye and the particle is painlessly lifted off with a small needle. After the particle has been lifted off it usually leaves an abrasion or ‘scratch’ on the cornea
• After a metal particle has been removed you may be left with a small amount of rust in the abrasion.  This can be removed after 2 days of treatment with antibiotic cream.
• The eye will remain painful until the abrasion has healed.  This can take between 24/48 hours.
• To reduce the pain a pain killing tablet such as paracetamol taken according to instructions may help.

What happens next?        

Usually after a foreign body is removed the eye will not need checking again.  We may ask you to come for a check of the eye is there is rust still in the abrasion after the foreign body is removed, or if your vision has been affected by the foreign body.

Treatment    

The abrasion is treated by putting ointment into the eye and may be padded closed.  You will then be asked to put the ointment in a few times a day for several days.

This leaflet will provide information to safely use your crutches

Crutches are used to help you walk or improve your balance after injury or surgery to your foot, knee, hip or leg. You will have been fitted with your new crutches and shown the proper way to use them. One important point to remember when using the underarm crutches is to put your weight through your arms and hands and not rest on your armpits. This could squeeze the nerves that supply your arms and cause tingling in your hands.

Proper positioning:

The top of your crutches should be about 1-1.5 inches below your armpits when you stand up straight.

The handles should be about even with your hip line.

Your elbows should be bent a bit when you use the handles

Squeeze the tops of the crutches against your side and press down on the handles

Use your crutches on firm ground and make sure the tips of your crutches are not split or loose

General guidelines:

• Remove scatter rugs, electrical cords, spills or anything else that may cause you to fall
• Simplify your house to keep the items you need handy and everything else out of the way
• Try using a backpack or apron to help you carry things around
• Wear sturdy shoes with non-slip soles that fit well. Avoid going barefoot, or wearing flip flops, loose slippers, and high heels

Take care with:

• Ice, snow or slippery surface
• Wet or waxed floor
• Walking around pets or children

Walking:

Lean forward slightly and put your crutches ahead of you. Place your injured leg/foot between the crutches, take the weight through the crutches and step through with your good leg.

Sitting down/standing up:

Back up to a sturdy chair. Rest your injured leg/foot in front of the other leg and hold the crutches in one hand. Use the free hand to put on the chair arm or seat. Lower to sit fully on the chair.

Turn the crutches upside-down to rest them (less likely to fall over)

To stand up shuffle to the front of the chair, push up on the chair and crutches, and stand up on the good leg.

Going Up Stairs:

1. Face the stairs. Place both crutches in one hand and your other hand on the hand railing.

2. Place your weight on both hands and lift your stronger leg up to the next step.

3. Move crutches and your weaker leg up to the same step. Move your hand up the railing.

4. Repeat steps 2-3 until you are at the top of the stairs.

Going Down Stairs:

1. Stand with the toes of your uninjured leg close to the edge of the step.

2. Place both crutches in one hand and your other hand on the railing.

3. Move the crutches and weaker leg down to the same step.

4. Bring your stronger leg down to the same step. Move your hand down the hand railing.

5. Repeat steps 3-4 until you are at the bottom of the stairs. 

This leaflet will provide information to help you recover from your elbow injury.

When you fall and injure your elbow you can damage the ligaments and tendons that support and move the elbow joint. This type of injury can cause pain, swelling and bruising. Your elbow will also feel limited in its movement and you may have difficulty bending your arm.

These symptoms are expected after this type of injury. It will heal, but it is important to do the correct treatment yourself to reduce the pain and swelling, and improve the movement.

Pain

If you feel the pain is severe enough to stop you sleeping then take some regular pain relief. Paracetamol taken regularly will help control the pain and allow you to exercise more comfortably. If you need a stronger painkiller such as Codeine then see your GP.

As the inflammation process of the injury needs to happen it is important that you don’t take Ibuprofen for the first 48 hours. If the swelling persists after this time then you can take Ibuprofen as well as the Paracetamol. If you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets. (Ibuprofen is not recommended if you have asthma, kidney disease or stomach problems)

Swelling

It is important to limit the amount of swelling you have as this can delay the healing.

You may have been given a sling to rest your elbow. If possible you need to rest the elbow in this position for at least the first 24-48 hours after the injury. However it is important to remove the sling regularly during this period, and to exercise the elbow to prevent stiffness and reduction of strength. Do this every one to two hours.

Ice packs

Using a proper ice pack on the elbow every two hours will also help both the pain and the swelling. Ideally use a large pack of frozen peas and wrap this in a tea towel that is wet with cold water (do not put the packet plastic in contact with your skin and do not leave on while you are asleep). Place this pack over the worst area of the elbow and press it on firmly. Wrap this in place tightly with a bandage, scarf or another towel. Keep this ice pack in place for 15-20 minutes. Immediately after do some gentle exercises as shown below.

Remember to put the peas back in the freezer so you can use them again but label them clearly so you don’t cook them by mistake. Repeat the icepack treatment every two hours.

Elbow  exercises

In a sitting or standing position, bend the elbow upwards aiming to touch your hand onto your shoulder Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In a sitting or standing position straighten the elbow by moving the hand down and away from you. Aim to try and get the elbow fully straight like the position on your other arm Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In a sitting or standing position hold your elbow into your side at a right angle position Turn your hand up towards the ceiling and then down to towards the floor by rotating your forearm Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.

Getting back to activity

True healing of the damaged tissues can take at least six weeks.

Activities such as swimming, stretching to wipe surfaces, and cleaning windows can help to maintain your general movement whilst the elbow mends but must be done gently.

Make sure that you have regained full movements of the elbow and that all the pain has settled before you return to any heavy work or sporting activity again.

Then you can start back to some light training or gym work and test your elbow out with specific sport exercises before playing competitively again.

The following is a summary of our discussions today together with advice for you to follow once you return home.

You have attended the Emergency Department (ED) with symptoms resembling a seizure, often referred to as a fit.  This normally involves loss of consciousness for less than or equal to 5 minutes with or without jerking type movements.

Post seizure/fit symptoms may include:

·        Unable to recall events for longer than 5 minutes.

·        Tongue biting.

·        Incontinence of urine.

·        Confusion.

·        Headache.

·        Fatigue (before or after sleep).

·        Weakness to one side of the body (Todd’s paresis).

When there is a clinical suspicion of a seizure without definite evidence, an outpatient First Fit Clinic appointment is made for you to see a Neurologist (medical specialist in the nervous system and disorders affecting it).

The clinic will contact you with a time and date for this appointment via phone or letter.

You will require appropriate specialist assessment and or investigations, for example an Electroencephalograph (EEG) and brain scan, if necessary to decide if you have had a seizure.

It is advisable to attend your First Fit Clinic appointment accompanied by someone who witnessed the seizure or fit.

Advice about driving before attending the First Fit Clinic

For safety reasons, the DLVA (Driver and Vehicle Licensing Agency) has strict guidelines and state that you must not drive.  For further information, visit:          www.gov.uk/epilepsy-and-driving.

You must:

·          Avoid potentially dangerous work/ leisure activities such as :

Ø   Swimming.

Ø   Climbing ladders.

Ø   Contact sports such as rugby, cricket, football etc.

·          Leave the bathroom/ WC door unlocked and bath/shower with supervision.

·          Avoid consuming alcohol.

You must NOT:

·          Operate dangerous machinery.

·          Cycle on busy roads.

If the above symptoms return then you should re-attend the Emergency Department.

First Fit Clinic contact details

01782 679459

Monday to Friday 8.00 am to 8.00pm

Saturday/Sunday 8.00am to 3.30pm

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language

What has happened?

You have broken a bone in your hand under your little finger.  This is often described as a boxer’s fracture.

What will happen now?

The position of the break is stable and should heal normally over the next 3-4 weeks, and continue to improve further over the next following months. Once healed it may still look as if there is a lump in your hand or that the little finger knuckle looks dropped – this is normal and it may appear like that for several months.

What treatment have I had?

You will have been given a splint to keep your little and ring fingers together.  This protects the fracture site but still allows you to bend your fingers and you will need to keep this on for one week.

Your hand may be swollen so please try to keep it elevated for the first 2-3 days or longer if the swelling continues.  Avoid using your hand excessively for the first 1-2 weeks to allow the healing to start.

What if it is painful?

You will have been advised about pain relief that is suitable for you.  Take some pain relief as you need to make your hand comfortable, but do not exceed the stated dose allowed.

What if I have a problem with my hand?

If you have increased pain, clicking, pins and needles or numbness in your hand or fingers please call and speak to member staff on 01782 674440  9am-8pm.

Keep this paper & quote the noted details below to them when you call.

A doctor or nurse practitioner has examined you to detect any immediate problems but does not feel you need to stay in hospital.  However, complications are not always immediately obvious following head injury, so careful observation for at least 24 hours by a responsible adult is vital.

Rest:

Avoid alcohol, driving and strenuous exertion

Avoid too much mental stress, too much reading, watching TV and computer games.

Meals:

Food and drink should be taken in light easily digestible amounts

Medication:

Unless otherwise advised, take only simple painkilling tablets like paracetamol, ibuprofen or soluble aspirin.

FOR THE ATTENTION OF THE PERSON LOOKING AFTER YOU

Most blows to the head do not lead to serious complications and we expect complete recovery.  However, you are advised to bring the patient back to hospital immediately if she or he:

• Becomes unconscious
• Become increasingly sleepy i.e. more than expected and usual times of rest and sleep.
• Complains of increasingly severe and persistent headache which is unrelieved by rest and simple painkilling tablets.
• Persistent vomiting
• Complains of blurred or double vision
• Has persistent dizziness or giddiness
• Has a fit, convulsion or sense or weakness in any limb

On-going problems:

 Some people experience headaches, dizziness and poor concentration for a long time after a head injury, even if the injury seemed minor at the time.  This is normal.  You should rest as much a possible, avoid alcohol, and try to limit time spent at a computer screen.

 You should only worry if your symptoms GET WORSE i.e. your headaches get more severe, you have a fit, your speech becomes slurred or you lose coordination.

 IF ANY OF THESE HAPPEN YOU SHOULD RETURN TO THE EMERGENCY DEPARTMENT IMMEDIATELY

This leaflet will provide information to help you recover from your knee injury.

When you twist or stretch your knee you can damage the ligaments and tendons that support and move the knee joint. This type of injury can cause pain, swelling and bruising. Your knee will also feel limited in its movement and you may have difficulty walking and have a limp.

These symptoms are expected after this type of injury. It will heal, but it is important to do the correct treatment yourself to reduce the pain and swelling, and improve the movement.

Pain

If you feel the pain is severe enough to stop you sleeping then take some regular pain relief. Paracetamol taken regularly will help control the pain and allow you to exercise more comfortably. If you need a stronger painkiller such as Codeine then see your GP.

As the inflammation process of the injury needs to happen it is important that you don’t take Ibuprofen for the first 48 hours. If the swelling persists after this time then you can take Ibuprofen as well as the Paracetamol. If you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets. (Ibuprofen is not recommended if you have asthma, kidney disease or stomach problems)

Swelling

It is important to limit the amount of swelling you have as this can delay the healing.

As soon as you get home you need to sit with your knee supported on a few pillows. Your knee has to be higher than your hip for gravity to help get rid of the swelling. If possible you should rest in this position for at least the first 24-48 hours after the injury. If the swelling continues after this time you need to spend as much of the day as possible in this elevated position as you can

Ice packs

Using a proper ice pack on the knee every two hours will also help both the pain and the swelling. Ideally use a large pack of frozen peas and wrap this in a tea towel that is wet with cold water (do not put the packet plastic in contact with your skin and do not leave on while you are asleep). Place this pack over the knee and press it on firmly. Wrap this in place tightly with a bandage, scarf or another towel. Keep this ice pack in place for 15-20 minutes. Immediately after do some gentle exercises as shown below.

Remember to put the peas back in the freezer so you can use them again but label them clearly so you don’t cook them by mistake. Repeat the icepack treatment every two hours.

Walking

You may find this difficult to start with due to the pain and stiffness. If you have been given crutches use these initially for the first 1-2 days until the pain and swelling is less and you can put your foot to the floor. Try to walk with a normal walking pattern as soon as possible – heel to the floor first, and then push off with your toes with the foot pointing forwards rather than sideways. Gradually build up the amount of walking you do over the next week, both in distance and speed, without overdoing it in the early stages. If you get a recurrence of the swelling after walking remember to sit with your knee elevated and try some more icepacks

Knee exercises

In a lying position try to slide your heel up to your bottom, hold for 5 seconds and then push away Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In a sitting position try to squeeze your knee flat into the floor, tighten your thigh muscles at the same time. Hold for 5 seconds. Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In a sitting position with a rolled towel under your knee, squeeze the thigh muscles until your foot is raised from the floor and your knee is straight. Hold for 5 seconds. Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In a sitting position squeeze your thigh muscles to straighten your knee, now raise your whole leg to lift your heel off the floor. Hold for 5 seconds. Try this 10 times at least 3-4 times a day. You may find that this is easier to do a few more days after the injury.

Getting back to activity

True healing of the damaged tissues can take at least six weeks.

Activities such as swimming, cycling and controlled walking can help to maintain your general fitness whilst the knee mends.

Make sure that you have regained full movements of the knee, that all the pain has settled and you can walk normally and quickly before you try running again.

Then you can start back to some light training or gym work and test your knee out with specific sport exercises before playing competitively again.

Rest and elevate your limb as much as possible for the first 48 hours.

Limbs in plaster should be kept raised for the first 2-3 days.  If allowed to hang by your side they may become swollen and the plaster may become too tight.

You will be given a sling to wear by the nursing staff to elevate your hand BUT it is very important that when you are resting, for example reading or watching TV, that:

·         You make sure that you keep your hand and elbow a little higher than your shoulder.  This will keep swelling of fingers and forearm to a minimum. This can be achieved by resting your elbow on 2-3 cushions or pillows.

·         Regularly exercise your fingers, elbow and shoulder

It is normal to still experience pain even though your arm is now in a plaster cast, HOWEVER:

PLEASE CONTACT THE PLASTER ROOM IF ANY OF THE FOLLOWING OCCUR:

·         The plaster becomes cracked, loose or soft

·         Your develop soreness or chafing

·         The pain or swelling is not relieved by pain killers and/or elevation

·         You have pins and needles or numbness

·         You cannot move your fingers

·         Your fingers become discoloured e.g. white or blue/purple

·         You have any concerns about your plaster or arm

Plaster room can be contacted Monday-Thursday 9am-5pm & Friday morning on 01782 676534.  You may be given an appointment time to return

If you have problems outside these hours please contact the Emergency Care Centre on 01782 674440.

PLEASE DO NOT GET YOUR PLASTER WET, ATTEMPT TO CUT YOUR PLASTER OR PUSH ANYTHING INSIDE YOUR PLASTER.

Your plaster will not be fully dry for 72 hours (2 hours for fibreglass) and you should treat it very carefully.

You should:

• Keep the limb in plaster raised when you are sitting for the first 24 hours rested on pillows
• Exercise all the parts not covered by the plaster i.e. shoulders, knee, fingers or toes
• Keep well hydrated

You should not:

• Get the plaster wet.
• Walk on the plaster unless you have been told you can do so.
• Heat the plaster as it will conduct and retain heat which may burn you.
• Scratch the skin under the plaster or stick anything such as knitting needles inside the cast.
• Let anyone write on the plaster until it is dry.
• Rest your plaster on anything hard.
• Take your plaster off.

GO TO YOUR NEAREST EMERGENCY DEPARTMENT OR WALK IN CENTRE AT ONCE IF:

 ·        Your fingers/toes become numb, blue, very cold or swollen and they do not get better even if you keep them raised for a while

·        The plaster is uncomfortable or is hurting you because it is too tight, too loose, or rubbing you.

·        The plaster becomes soft or cracks

If you have been referred for Physiotherapy treatment for your acute soft tissue injury. It is important that you seek early treatment.  Please telephone the Physiotherapy Department on 01782 676570 after 10am the next working day to arrange an appointment.

If you do not have access to a telephone please inform the Accident & Emergency Department before you leave today.

If you do not contact the physiotherapy department within 7 days it will be assumed you do not require treatment and you will be discharged.

The physiotherapy department is located within the Trent Building at the City General.  Parking your car can be difficult so please allow plenty of time.  There is a drop off bay outside the Trent Building

Getting here.

The wound on your shin is called a pre-tibial laceration.  It is not like a simple cut and may take many weeks to heal fully.

We sometimes use paper stitches called steristrips on this type of cut because the skin is too thin to use normal stitches, or we may just use a special dressing.

We have put a bandage on from your toes to your knee to make sure that the circulation to your legs stays even.  This will help the cut heal well.

You should:

·        Keep the bandage on until you visit your GP or the Central Treatment Suite.

·        Walk around as normal

·        Keep your foot raised on a stool when you are sitting down.  Your foot should be higher than your hip.

·        Take tablets such as ibuprofen or paracetamol (both available from a chemist) to relieve any pain.

You should not:

• Get your bandage wet.
• Stand still – don’t do jobs like ironing or washing up until your cut is better.
• Remove the dressing.

Go to your GP, Walk-in-Centre or the nearest Emergency Department if:

 ·        Your leg bleeds a lot making the bandage very wet.

·        Your leg becomes very swollen.

·        You are worried about your leg for any reason

This leaflet will provide information to help you recover from your shoulder injury.

When you fall and injure your shoulder you can damage the ligaments and tendons that support and move the shoulder joint. This type of injury can cause pain, swelling and bruising. Your shoulder will also feel limited in its movement and you may have difficulty raising your arm.

These symptoms are expected after this type of injury. It will heal, but it is important to do the correct treatment yourself to reduce the pain and swelling, and improve the movement.

Pain

If you feel the pain is severe enough to stop you sleeping then take some regular pain relief. Paracetamol taken regularly will help control the pain and allow you to exercise more comfortably. If you need a stronger painkiller such as Codeine then see your GP.

As the inflammation process of the injury needs to happen it is important that you don’t take Ibuprofen for the first 48 hours. If the swelling persists after this time then you can take Ibuprofen as well as the Paracetamol. If you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets. (Ibuprofen is not recommended if you have asthma, kidney disease or stomach problems)

Swelling

It is important to limit the amount of swelling you have as this can delay the healing.

You may have been given a sling to rest and elevate your shoulder. If possible you need to rest the shoulder in this position for at least the first 24-48 hours after the injury. However during this period it is important to remove the sling regularly (i.e. every 1-2 hours), to exercise the shoulder to prevent stiffness and reduction of strength.

Ice packs

Using a proper ice pack on the shoulder every two hours will also help both the pain and the swelling. Ideally use a large pack of frozen peas and wrap this in a tea towel that is wet with cold water (do not put the packet plastic in contact with your skin and do not leave on while you are asleep).

Place this pack over the worst area of the shoulder and press it on firmly. Wrap this in place tightly with a bandage, scarf or another towel. Keep this ice pack in place for 15-20 minutes. Immediately after do some gentle exercises as shown below.

Remember to put the peas back in the freezer so you can use them again but remember to label them clearly so you do not cook them by mistake. Repeat the icepack treatment every two hours.

Shoulder exercises

In a lying position raise your hands using your healthy arm to assist your injured shoulder. Try to take your arm over your head as much as pain will allow. Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In a lying position, place you arm out to the side with your elbow bent and hand facing upwards. Rotate your upper arm, taking your hand down towards your hip and then up towards your head Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
In standing position lean forward and support yourself on the back of a chair with your injured shoulder dangling forwards. Relax and swing the injured arm forwards and backwards like a pendulum. Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
Standing facing a wall; gradually walk with your finger tips up the wall aiming to reach as high as possible. Walk both hands up the wall together, so you may see how high you should be able to reach. Try this 10 times at least 3-4 times a day.
In a standing or sitting position raise your arm out to the side to reach above your head. Try this 10 times at least 3-4 times a day. You may find that this is easier to do a few more days after the injury.
In a standing or sitting position raise both arms out in front to reach above your head. Use your other arm to help if needed Try this 10 times at least 3-4 times a day. You may find that this is easier to do a few more days after the injury.

Getting back to activity

True healing of the damaged tissues can take at least six weeks.

Activities such as swimming, stretching to dust the table and cleaning windows, gently can help to maintain your general movement whilst the shoulder mends.

Make sure that you have regained full movements of the shoulder and that all the pain has settled before you return to any sporting activity again.Then you can start back to some light training or gym work and test your shoulder out with specific sport exercises before playing competitively again.

Your nose is swollen at the moment, so it may look worse than it really is.  We will not x-ray it as this does not affect our decision on how to treat you.  If your nose is clearly deformed an appointment will be made for you to see a specialist.  If your nose is swollen but not deformed, we will leave this to heal on its own.

 YOU SHOULD:

• Use ice packs (frozen peas in a cold damp towel) for 10 minutes, 3-4 times a day to reduce the swelling.
• Take tablets such as ibuprofen or paracetamol (both available from a chemist) to relieve the pain.

YOU SHOULD NOT:

• Blow your nose or pick at any scabs – it may start to bleed.

If your nose starts to bleed, you should:

• Sit down calmly in a chair, with your head down and a bowl in your lap
• Press firmly on all of the soft part of your nose, just below the bony part.  It will not help to squeeze the bony (hard) part.
• Press firmly and continuously, almost to the point of discomfort, for at least 10 minutes while breathing through an open mouth.
• Spit any blood in your mouth into the bowl
• If bleeding continues keep pressing on the soft part of your nose but also apply a cold compress to your forehead.  You can use ice wrapped in a wet towel or a bag of frozen peas wrapped in towel.  The cold compress will reduce the supply of blood  to your nose.
• If the bleeding continues for more than 20 minutes or you feel faint then go to your local emergency department, taking any medication you take with you.  It may be necessary to pack your nose with absorbable packs.

You should not swallow any of the blood or the clots as this will make you sick, as you vomit or retch your nose will bleed even more.

If after 3-5 days when the swelling settles you think your nose is deformed please contact us so we can arrange follow-up with a specialist.

They suspect that you may have a fracture (broken bone) in a small bone called the scaphoid, which is in the wrist around the bottom of your thumb.  The splint you have been given to wear is to stabilise and support this bone until a fracture is confirmed.  You should wear this splint at all times but may take it off for a short period to bathe or shower.

Not wearing the splint can prevent the bone healing, which can cause long term pain and sometimes disability in the wrist.

You will be given an appointment for the hand clinic 10-14 days after the injury. You should wear your splint everyday as instructed until you have been to the hand clinic to have the break confirmed.  The specialists in the clinic will advise you on what to do next for the injury.

Being given this treatment does not mean that there is a definite fracture/break in the bone, but that a fracture is suspected.

Tendons are strong soft tissue structures and often join muscles to bone to help make your joints move.  If a tendon is overused, used in the wrong position or damaged then it can become inflamed.  This can result in it becoming painful and swollen.  It is important to manage the inflammation well so that the problem doesn’t become more permanent.

Pain:

If you feel the pain is severe enough to stop you sleeping then take some regular pain relief.  Paracetamol taken regularly will help control the pain but if you need a stronger painkiller such as codeine then see your GP.

If you are able to, start taking Ibuprofen as well as the paracetamol.  However, if you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets.   Ibuprofen is not recommended if you have asthma, kidney disease or stomach problems.

Swelling:

It is important to reduce the amount of swelling you have as this can delay the healing.  Try to keep the inflamed area elevated so that gravity can help to reduce the swelling.

Rest:

It is important to rest the inflamed area and stop any activity that may have caused the inflammation.  You may have been given some sort of splint or support.  Use this for several days to give the inflammation time to settle.

Ice-packs:

Using an ice-pack over the inflamed are every couple of hours will help both the pain and swelling.  Ideally use a small pack of frozen peas and wrap this in a cold damp tea-towel (do not put the packet plastic in direct contact with your skin and do not leave it on while you are asleep).  Place this pack over the swollen area and press on firmly.  Wrap the pack in place with a bandage, scarf or another towel.  Keep the ice pack in place for 15-20 minutes.  Afterwards do some gentle pain free range of movement exercises, but only 5 repetitions.

Remember to put the peas back in the freezer so you can use them again and label them clearly so that you don’t cook them by mistake.  Repeat the icepack treatment every two hours.

Getting back to activity:

It can take up to 6 weeks for the inflammation to settle properly.  You can try light activities before this time if it does not cause you pain.  Make sure you regain your full movement and strength before attempting heavy work or sporting activities.

This leaflet will provide information to help you recover from your thumb or finger injury.

You can injure your thumb and fingers due to a fall, direct blow or overuse. This can damage the ligaments and tendons that help to support and move the small joints. These types of injuries can cause pain, swelling and bruising. Your joints may also feel limited in their movement and you may have difficulty using your hand properly and making a fist to grip things.

These symptoms are expected following injury or overuse. It will heal, but it is important to do the correct treatment to assist yourself to reduce the pain, swelling and improve the movement.

Pain

If you feel the pain is severe enough to stop you sleeping then take some regular pain relief. Paracetamol taken regularly will help control the pain and allow you to exercise more comfortably. If you need a stronger painkiller such as Codeine then see your GP.

As the inflammation process of the injury needs to happen it is important that you don’t take Ibuprofen for the first 48 hours. If the swelling persists after this time then you can take Ibuprofen as well as the Paracetamol. If you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets. (Ibuprofen is not recommended if you have asthma, kidney disease or stomach problems)

Swelling

It is important to limit the amount of swelling you have as this can delay the healing.

You may have been given a sling to rest and elevate your hand. You can also rest with your hand elevated on some cushions. However it is important to remove the sling regularly during the first two days, to exercise the thumb and fingers to prevent stiffness and reduction of strength.

Ice packs

Using a proper ice pack around the hand every two hours will also help both the pain and the swelling. Ideally use a small pack of frozen peas and wrap this in a tea towel that is wet with cold water (do not put the packet plastic in contact with your skin and do not leave on while you are asleep).

Place this pack over the joints with the most swelling and press it on firmly. Wrap this in place tightly with a bandage, scarf or another towel. Keep this ice pack in place for 15-20 minutes. Immediately after do some gentle exercises as shown below.

Remember to put the peas back in the freezer so you can use them again and label them clearly so that you don’t cook them by mistake. Repeat the icepack treatment every two hours.

Alternatively you can place your hand in a bowl of very cold water containing some ice cubes. Let your fingers and thumb go cold and try and do some gentle gripping exercises in the water. Don’t leave your hand in the water any longer than 10 minutes.

Repeat the ice or water treatment every two hours

Thumb and finger exercises

To help with the swelling in your fingers and palm, hold your hand upwards and open and close your fingers making a fist. Try this 10 times at least 3-4 times a day.
Have your palm in an open position. Bring your thumb down across your palm towards the base of your little finger and back again Try this 10 times at least 3-4 times a day.
Hold the base of your thumb with your other hand. Try to bend the end joint of your thumb down and up Try this 10 times at least 3-4 times a day.
Have your palm in an open position. Try to circle your thumb first in a clockwise direction, then anticlockwise Try this 10 times in both directions at least 3-4 times a day.
Try to touch your thumb to the tip of your index finger and then to your middle, ring and little finger tips Try this 10 times at least 3-4 times a day.
Keep your fingers and thumb straight and try to spread them apart and close them together Try this 10 times at least 3-4 times a day

Getting back to activity

True healing of the damaged tissues can take at least six weeks.

Injuring your thumb and hand can limit your day to day function so it is really important to do the exercises regularly and reduce the swelling. It may be more difficult if you have injured your dominant hand, but try to start using your hand for normal functional activities as soon as the pain allows.

Pain will limit the strength of your thumb so be careful lifting heavier objects (kettles, pans, boxes etc) for the first few days.

Make sure you regain your full thumb movement and strength before attempting very heavy work or sporting activities.

The following is a summary of our discussions together with advice for you to follow once you return home.

·        You have attended the Emergency Department (ED) with symptoms resembling a TIA (Transient Ischaemic Attack).

·        A TIA is similar to a Stroke but the symptoms are only temporary, lasting between a few minutes and 24 hours.

·        A TIA is a warning sign that there may be a risk of a further Stroke in the near future and therefore should not be ignored.

·        Due to your symptoms, your clinical information has been passed to the TIA Clinic where further specialist knowledge and investigations may be needed in order to confirm or rule out a diagnosis of TIA.

·        Your clinical information will be triaged (assessed) by a Stroke Consultant and you will then be categorised as high or low risk, depending on your risk factors.  If you are suspected of having a TIA, you will be offered an appointment.

·        Should the Stroke Consultant decide that your symptoms are not a TIA, you will not be offered an appointment and your care will be passed back to your GP. 

·        You will then be contacted either by phone or by post within the next week to confirm your appointment, so please answer unknown calls during this week. 

·        If you have not received any information within the next 5 days, please call the TIA Clinic.  The answer machine is checked regularly should you wish to leave a message.

·        You will be asked to take an aspirin once a day until seen in the TIA Clinic, unless:

Ø  You have an allergy.

Ø  Are on anticoagulants.

Ø  Have a condition where you are advised not to take aspirin.

Ø  You are already taking aspirin.

Advice about driving

For safety reasons, the DLVA (Driver and Vehicle Licensing Agency) has strict guidelines about who may and may not drive.  

YOU ARE NOT ALLOWED TO DRIVE FOR AT LEAST 28 DAYS AFTER A TIA. This is because of the possible effects and the risk of a further Stroke after your TIA

This guidance may change after you have been assessed in the TIA Clinic.

In the meantime, should you be involved in an accident, your car insurance would not be valid.  You do not need to inform your insurance company at this point however, you must do so should a diagnosis of TIA be confirmed.

What do I do if the symptoms return?

Once you have been discharged from ED, should you experience similar symptoms again before the TIA Clinic appointment, please attend the ED again immediately by calling 999.

TIA Clinic contact details

01782 675356

Monday to Friday 8.00 am to 8.00pm

Saturday/Sunday 8.00am to 3.30pm

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language

This leaflet will provide information to help you recover from your wrist injury.

You can injure your wrist due to a fall, direct blow or overuse. This can damage the ligaments and tendons that help to support and move the wrist joint. These types of injuries can cause pain, swelling and bruising. Your wrist will also feel limited in its movement and you may have difficulty turning your hand over and gripping. The swelling and stiffness can also spread to the fingers and thumb.

These symptoms are expected following injury or overuse. Your injury will heal, but it is important to do the correct treatment to assist you to reduce the pain and swelling, and improve the movement.

Pain

If you feel the pain is severe enough to stop you sleeping then take some regular pain relief. Paracetamol taken regularly will help control the pain and allow you to exercise more comfortably. If you need a stronger painkiller such as Codeine then see your GP.

As the inflammation process of the injury needs to happen it is important that you don’t take Ibuprofen for the first 48 hours. If the swelling persists after this time then you can take Ibuprofen as well as the Paracetamol. If you have asthma or stomach problems then please discuss with your doctor whether you can take any form of anti-inflammatory tablets. (Ibuprofen is not recommended if you have asthma, kidney disease or stomach problems)

Swelling

This usually occurs soon after the injury, but bruising may appear later on.

It is important to limit the amount of swelling you have as too much can delay the healing.

You may have been given a sling to rest and elevate your wrist and hand. You can also rest with your hand elevated on some cushions. If you are using a sling it is important to remove it regularly during the first two days, to exercise the wrist to prevent stiffness and reduction of strength.

Ice packs

Using a proper ice pack on the wrist every two hours will also help both the pain and the swelling. Ideally use a large pack of frozen peas and wrap this in a tea towel that is wet with cold water (do not put the packet plastic in contact with your skin and do not leave on while you are asleep).

Place this pack over the worst area of the wrist and press it on firmly. Wrap this in place tightly with a bandage, scarf or another towel. Keep this ice pack in place for 15-20 minutes. Immediately after do some gentle exercises as shown below.

Remember to put the peas back in the freezer so you can use them again but label them clearly so you don’t cook them by mistake.

 Repeat the icepack treatment every two hours.

Wrist exercises

Sit comfortably with forearms supported and palms facing down. Bend your wrist up with your fingers towards the ceiling, and then bend your wrist down pointing your fingers towards the floor. Try this 10 times at least 3-4 times a day. For the first few days it may be more comfortable to do this after the ice pack has been on.
Put your hands in the prayer position and use your good hand to bend your stiff wrist back further Try this 10 times at least 3-4 times a day.
Sitting with your forearm supported rotate your forearm till the palm faces upwards and then rotate the other way so the palm faces downwards Try this 10 times at least 3-4 times a day.
To help with the swelling in your fingers and palm, hold your hand upwards and open and close your fingers making a fist. Try this 10 times at least 3-4 times a day.

Getting back to activity

True healing of the damaged tissues can take at least six weeks.

Injuring your wrist and hand can limit your day to day function so it is really important to do the exercises regularly and reduce the swelling. It may be more difficult if you have injured your dominant hand, but try to start using your hand for normal functional activities as soon as the pain allows.

Pain will limit the strength of your hand so be careful lifting heavier objects (kettles, pans, boxes etc) for the first few days.

Make sure you regain your full wrist movement and strength before attempting very heavy work or sporting activities.

There are many different types of wound, and we have many different ways of treating them.

Your wound may have been treated with:

STITCHES

You have __x_____ stitches, please have them removed in__x____ days.  You will need to make an appointment with your GP or practice nurse to have them removed.

STERISTRIPS

These can be taken off in 5 to 7 days.  You should dampen the steristrips for 10 minutes and carefully peel them off the wound, take care not to pull too much on the wound edges.

GLUE

This is special medical glue.  The glue forms a scab which will drop off by itself when the wound is healed.  Keep the wound dry for the first 5 days, and then you can wash it with care.

YOU SHOULD:

• Keep the wound clean and dry for 5 days
• Wash around it with care
• Leave any dressings on for 5 days

YOU SHOULD NOT:

• Cover the wound with anything waterproof unless the doctor or nurse tells you to - this can make the wound soggy and more likely to get infected.
• Pick off any scabs that form on the wound

GO TO YOUR GP OR NEAREST EMERGENCY DEPARTMENT OR WALK IN CENTRE IF:

• Any fluid comes from the wound
• It is painful, red or swollen
• Your wound re-opens, there is only a small chance that this will happen

PLEASE REMEMBER: it may take six months or more for the scar to fade.