2017 HCHB_digital

Sore Throat
Sore throats are very common and symptoms can vary from a mild scratchiness at
the back of the throat to severe pain. Visually, the throat may look dry and red and
the tonsils inflamed and swollen. Often, lymph nodes in the neck become enlarged
and tender and can be easily felt from the outside of the neck. It may be hard for
the person to swallow and their voice may sound husky or hoarse.
Sore throats can be associated with colds and flu, tonsillitis (inflammation
of the tonsils caused by a bacterial or viral infection), or strep throat. Viruses
account for almost 90% of all infections, with the cold virus the most common
cause. The Epstein-Barr virus, which is responsible for glandular fever and the
measles virus can also cause sore throat. If a cause other than a cold virus is
suspected, the person should be referred to the pharmacist.
Products available for viral sore throats temporarily relieve the pain associated
with the sore throat. Products include oral and topical analgesics, and numbing
sprays or lozenges. Even sucking non-medicated lozenges can provide some relief as
the action of sucking produces saliva, which lubricates and soothes inflamed tissue.
streptococcal (strep) sore throats
Sore throats produced by Group A streptococcal bacteria tend to be more severe
and persistent than other causes of sore throats. Symptoms may include a distinct
pattern of white patches on the back of the throat or a high fever. Occasionally
the person may develop a rash that feels rough to the touch. It may start on the
neck and chest and eventually spread to the whole body. A strep throat infection
accompanied by this distinctive rash is known as scarlet fever. The rash is caused
by toxins produced by the streptococcal bacteria.
Strep throats are more prevalent in people aged three to 45 years, particularly
those under 15, and are highly infectious. If one person in a family develops a
strep throat, then all members of a household should be tested for the presence
of the bacteria. Refer anybody with a suspected strep throat particularly in areas
of high strep throat occurrence to a free sore throat clinic (see www.health.
govt.nz or call Healthline on 0800 611 116 for locations), or a doctor because
untreated infections can result in rheumatic fever (an inflammatory disease that
can permanently damage the heart) or kidney disease. Rheumatic fever is more
common in Maori and Pacific Islanders, especially those in overcrowded living
conditions. Always refer Maori or Pacific children aged four to 19 with a sore
throat.
Initial assessment
Ask your customer for a description of their symptoms, or if appropriate, don a
face mask and gloves and take them to a private area to look at their throat. Try
to assess the degree of redness (ie, mild, moderate or severe) and look for any
unusual features (such as white patches on the back of the throat or pus). Refer
any customers with "yes" answers to the Refer to Pharmacist questions to
a pharmacist.
Refer to
PHARMACIST
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial assessment
may have already provided some answers. Decide if any further
questions still need to be asked and refer any “yes” answers to a
pharmacist.
• Does the person have any other health conditions (eg, heart or
lung problems, diabetes, is pregnant or breastfeeding)?
• Does the person take any other medicine or complementary
products, either prescribed by a doctor or bought from a shop?
• Is the person a child aged less than 19 years?
• Are the lymph nodes really swollen?
• Is there any sign of pus or ulceration?
• Are there any other symptoms, such as a rash, fever, vomiting, ear
pain, breathlessness or generally feeling unwell?
• Is swallowing extremely difficult, or preventing the person from
drinking anything. Are they showing signs of dehydration?
• Are there any white patches visible on the throat or tonsils?
• Has swallowing been difficult for a long time (eg, weeks)?
• Does the person often get sore throats?
• Has the person taken any new medicine recently?
• Does the person have any allergies to medicines?
chicken soup. Avoid crunchy or spicy foods with severe sore throats. Increase
water and fluid intake to offset dehydration.
• Rest as much as you can. Talk to a doctor if your sore throat does not get
better within a few days.
• Regular sucking of lozenges or pastilles stimulates saliva, which will lubricate
and soothe sore throats. Do not exceed the recommended dosage.
• Avoid smoking – it can make a sore throat feel worse.
• Cough into the crook of your elbow or cover your mouth with a tissue when
you sneeze or cough to avoid spreading your sore throat. Wash your hands or
use a sanitising hand gel immediately if you cough on your hands.
• Wash hands thoroughly before preparing food and before and after tending
to small children.
Advice for customers
• Eat cool, soft food such as smoothies and drink cool or warm liquids such as
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Page 140 HEALTHCARE HANDBOOK 2017-2018 Common Disorders