отек нижних конечностей

Content

Who is most at risk?

Level one alert: be prepared

Level two alert: heatwave is forecast

Level three alert: when a heatwave is happening

Tips for coping in hot weather

Level four alert: severe heatwave

How do I know if someone needs help?

Most of us welcome hot weather, but when it's too hot for too long there are health risks. If a heatwave hits this summer, make sure the hot weather doesn't harm you or anyone you know.

The main risks posed by a heatwave are: 

• dehydration (not having enough water)
• overheating, which can make symptoms worse for people who already have problems with their heart or breathing
• heat exhaustion and heatstroke

Who is most at risk?

A heatwave can affect anyone, but the most vulnerable people are:

• older people, especially those over 75
• babies and young children
• people with a serious chronic condition, especially heart or breathing problems
• people with mobility problems – for example, people with Parkinson's disease or who have had a stroke
• people with serious mental health problems
• people on certain medications, including those that affect sweating and temperature control
• people who misuse alcohol or drugs
• people who are physically active – for example, labourers or those doing sports

Level one alert: be prepared

The Meteorological Office has a warning system that issues alerts if a heatwave is likely. Level one is the minimum alert and is in place from June 1 until September 15 (which is the period that heatwave alerts are likely to be raised).

Although you don't have to do anything during a level one alert, it is advisable to be aware of what to do if the alert level is raised. Knowing how to keep cool during long periods of hot weather can help save lives.

Public Health England (PHE) has advice on how to stay safe during a heatwave (PDF, 417kb).

Level two alert: heatwave is forecast

The Met Office raises an alert if there is a high chance that an average temperature of 30C by day and 15C overnight will occur over the next two to three days. These temperatures can have a significant effect on people's health if they last for at least two days and the night in between.

Although you don't need to take any immediate action, follow these steps in preparation:

• Stay tuned to the weather forecast on the radio, TV or social media, or the Met Office.
• If you're planning to travel, check the forecast at your destination.
• Learn how to keep cool at home with the beat the heat checklist (PDF, 193kb).

Level three alert: when a heatwave is happening

This alert is triggered when the Met Office confirms there will be heatwave temperatures in one or more regions.

Follow the instructions for a level two alert. The following tips apply to everybody when it comes to keeping cool and comfortable, and reducing health risks.

Tips for coping in hot weather

• Shut windows and pull down the shades when it is hotter outside. You can open the windows for ventilation when it is cooler.
• Avoid the heat: stay out of the sun and don't go out between 11am and 3pm (the hottest part of the day) if you're vulnerable to the effects of heat.
• Keep rooms cool by using shades or reflective material outside the windows. If this isn't possible, use light-coloured curtains and keep them closed (metallic blinds and dark curtains can make the room hotter).
• Have cool baths or showers, and splash yourself with cool water.
• Drink cold drinks regularly, such as water and diluted fruit juice. Avoid excess alcohol, caffeine (tea, coffee and cola) or drinks high in sugar.
• Listen to alerts on the radio, TV and social media about keeping cool. 
• Plan ahead to make sure you have enough supplies, such as food, water and any medications you need.
• Identify the coolest room in the house so you know where to go to keep cool.
• Wear loose, cool clothing, and a hat and sunglasses if you go outdoors.
• Check up on friends, relatives and neighbours who may be less able to look after themselves.

If you're worried about yourself or a vulnerable neighbour, friend or relative, you can contact the local environmental health office at your local authority.

Environmental health workers can visit a home to inspect it for hazards to health, including excess heat. Visit GOV.UK to find your local authority.

Level four alert: severe heatwave

This is the highest heatwave alert in Britain. It is raised when a heatwave is severe and/or prolonged, and is an emergency situation.

At level four, the health risks from a heatwave can affect fit and healthy people, and not just those in high-risk groups. These groups include the elderly, the very young and people with chronic medical conditions.

Follow the information given above for a level three alert. Check that anyone around you who is in a high-risk group is coping with the heat.

How do I know if someone needs help?

Seek help from a GP or contact NHS 111 if someone is feeling unwell and shows symptoms of:

• breathlessness
• chest pain
• confusion
• intense thirst
• weakness
• dizziness 
• cramps which get worse or don't go away 

Get the person somewhere cool to rest. Give them plenty of fluids to drink. 

Find out about the symptoms of heat exhaustion.

Source http://www.nhs.uk/livewell/summerhealth/pages/heatwave.aspx

Contents

Considerations

Causes

Home Care

When to Contact a Medical Professional

What to Expect at Your Office Visit

Painless swelling of the feet and ankles is a common problem, especially among older people.

Abnormal buildup of fluid in the ankles, feet, and legs can cause swelling. This fluid buildup and swelling is called edema.

Considerations

Painless swelling may affect both legs and may include the calves or even the thighs. The effect of gravity makes the swelling most noticeable in the lower part of the body.

Causes

Foot, leg, and ankle swelling is common when the person also:

·         Is overweight

·         Has a blood clot in the leg

·         Is older

·         Has a leg infection

·         Has veins in the legs that cannot properly pump blood back to the heart

Injury or surgery involving the leg, ankle, or foot can also cause swelling. Swelling may also occur after pelvic surgery, especially for cancer.

Long airplane flights or car rides, as well as standing for long periods of time, often lead to some swelling in the feet and ankles.

Swelling may occur in women who take estrogen, or during parts of the menstrual cycle. Most women have some swelling during pregnancy. More severe swelling during pregnancy may be a sign of preeclampsia, a serious condition that includes high blood pressure and swelling.

Swollen legs may be a sign of heart failure, kidney failure, or liver failure. In these conditions, there is too much fluid in the body.

Certain medicines may also cause your legs to swell. Some of these are:

·         Antidepressants, including MAO inhibitors and tricyclics

·         Blood pressure medicines called calcium channel blockers

·         Hormones, such as estrogen (in birth control pills or hormone replacement therapy) and testosterone

·         Steroids

Home Care

Some tips that may help reduce swelling:

·         Put your legs on pillows to raise them above your heart while lying down.

·         Exercise your legs. This helps pump fluid from your legs back to your heart.

·         Follow a low-salt diet, which may reduce fluid buildup and swelling.

·         Wear support stockings (sold at most drugstores and medical supply stores).

·         When traveling, take breaks often to stand up and move around.

·         Avoid wearing tight clothing or garters around your thighs.

·         Lose weight if you need to.

Never stop taking any medicines you think may be causing swelling without first talking to your health care provider.

When to Contact a Medical Professional

Call 911 if:

·         You feel short of breath.

·         You have chest pain, especially if it feels like pressure or tightness.

Call your provider right away if:

·         You have heart disease or kidney disease and the swelling gets worse.

·         You have a history of liver disease and now have swelling in your legs or abdomen.

·         Your swollen foot or leg is red or warm to the touch.

·         You have a fever.

·         You are pregnant and have more than just mild swelling or have a sudden increase in swelling.

Also call your provider if self-care measures do not help or swelling gets worse.

What to Expect at Your Office Visit

Your provider will take a medical history and do a thorough physical examination, paying special attention to your heart, lungs, abdomen, lymph nodes, legs, and feet.

Your provider will ask questions like the following:

·         What body parts swell? Your ankles, feet, legs? Above the knee or below?

·         Do you have swelling at all times or is it worse in the morning or evening?

·         What makes your swelling better?

·         What makes your swelling worse?

·         Does the swelling get better when you raise your legs?

·         Have you had blood clots in your legs or lungs?

·         Have you had varicose veins?

·         What other symptoms do you have?

Diagnostic tests that may be done include:

·         Blood tests such as a CBC or blood chemistry

·         Chest x-ray or extremity x-ray

·         Doppler ultrasound examination of your leg veins

·         ECG

·         Urinalysis

Your treatment will focus on the cause of the swelling. Your provider may prescribe diuretics to reduce the swelling, but these can have side effects. Home treatment for leg swelling that is not related to a serious medical condition should be tried before drug therapy.

Source: https://medlineplus.gov/ency/article/003104.htm