Hand, foot and mouth disease is an acute disease. As soon as it starts, ordinary patients will have symptoms of fever, oral pain, anorexia and scattered herpes or ulcers in oral mucosa. If it is a severe patient, symptoms such as meningitis, encephalitis, encephalomyelitis, pulmonary edema, convulsion, increased or decreased heart rate, shallow or weak pulse or even disappearance may occur within 1-5 days after onset, which is very dangerous and fatal.
Hand, foot and mouth began to improve on the first day. Ordinary patients began to get better from the third day to the fifth day. The specific occurrence mode is as follows:
1, incubation period-onset symptoms Most patients with hand, foot and mouth disease have sore throat and fever immediately after onset, and their body temperature is about 38℃, which is similar to cold symptoms, accompanied by digestive tract symptoms such as nausea, vomiting and diarrhea. Soon, small herpes appeared on the oral mucosa, gums, tongue and palate, and then decomposed to form small ulcers, similar to aphtha, with obvious burning pain.
2. 1-2 days after the onset, sesame or rice-sized, gray-white, opaque and round blisters appeared at the distal ends of hands and feet, with several or dozens of them distributed centrifugally, with no pain, no itching or mild itching, and skin lesions distributed in palms, soles, buttocks, armpits and other places.
3. After 3-5 days of onset, herpes fluid in all parts of the body began to absorb and contract, dry and desquamate, showing signs of improvement, and most patients' fever symptoms returned to normal within 5 days.
4, 5-7 days after the onset of hand, foot and mouth disease patients in 5-7 days after the onset, if the symptoms are mild, usually have shown a basic recovery phenomenon, such as herpes subsided, rash disappeared, and body temperature was normal. If symptoms such as fever appear at this time, it means that herpes may have been infected, or improper nursing has caused fever causes such as bacterial pneumonia and respiratory infection.
5. From 7 days to 2 weeks after onset, herpes or oral ulcer in a few patients will gradually subside, and it may take two weeks to completely subside. Parents should pay attention that as long as they have herpes, they should isolate their children at home, because herpes fluid contains viruses that may be transmitted to other children.
3 how to care for hand, foot and mouth disease patients through disinfection and isolation Once they are found to be infected with hand, foot and mouth disease, the baby should seek medical treatment in time to avoid contact with the outside world. Generally, it needs to be isolated for 2 weeks until fever, rash subsides and blisters scab. Baby's used items should be thoroughly disinfected and soaked with chlorine-containing disinfectant. Items that are not suitable for soaking can be exposed to the sun. The baby's room should be ventilated regularly to keep the air fresh, circulating and at the right temperature. Conditional families can use lactic acid fumigation for air disinfection every day. Reduce the number of people entering and leaving the nursery, prohibit smoking, prevent air pollution and avoid secondary infection.
Oral care babies will refuse to eat, salivate, cry and sleep because of oral pain. In order to keep your baby's mouth clean, rinse your mouth with normal saline before and after meals. For babies who can't gargle, gently clean their mouth with a cotton swab dipped in normal saline. Vitamin B2 powder can be directly applied to oral erosion, or cod liver oil, or taken orally with vitamin B2 and vitamin C, supplemented by ultrasonic atomization inhalation, so as to relieve pain, promote early healing of erosion and prevent secondary bacterial infection.
Rash care 1, baby clothes and bedding should be clean, comfortable and soft, and changed frequently.
2. Cut your baby's nails and wrap your baby's hands if necessary to prevent scratching the rash.
3. A baby with a rash on the buttocks should clean up the urine and urine at any time to keep the buttocks clean and dry.
4, hand and foot rash can be coated with calamine lotion in the early stage, and 0.5% iodophor can be coated when herpes forms or herpes breaks.
5, pay attention to keep the skin clean, to prevent skin double infection.
Pay attention to cooling children's hand, foot and mouth disease is generally low-grade fever or moderate fever, which can make the baby drink more water without special treatment. Babies whose body temperature is between 37.5℃ and 38.5℃ are given physical cooling, such as cooling, drinking more warm water, taking a warm bath, etc. Change clothes in time during fever reduction and after sweating to prevent catching cold. When the high fever persists, you should take medicine to cool down according to the doctor's advice.
Recommended: physical antipyretic method
Massage to reduce fever
1, a nest of wind 500 times.
Operation: Rotate clockwise to knead the midpoint of the horizontal stripes on the back wrist of the operator's left hand.
Efficacy: relieving exterior syndrome and dispelling cold has the effect of warming middle energizer and dispelling cold.
2. Push Level 3 300 times
Operation: Push along the front of forearm, from the wrist striation to the elbow (one-way push, not back and forth).
Efficacy: It can nourish lung qi, sweat and relieve exterior syndrome.
3. Rub the migrant workers' palace 500 times.
Operation: Rotate clockwise to knead the middle part of the metacarpal bone of the operator's left hand, middle finger on the back of palm and ring finger.
Efficacy: Warming the middle warmer, dispelling cold, sweating and relieving exterior syndrome, and regulating qi and blood inward.
4, Qingtianhe 500 times
Operation: The operator holds the operator's palm with one hand, palm up, then holds Neilaogong point, and then puts the index finger and middle finger together with the other hand, pushing them from the wrist to the elbow.
Efficacy: clearing away heat and relieving exterior syndrome.
lukewarm bath
Dip a towel in warm water (the water temperature should not be too hot) and wipe it on the neck, armpit and thigh root for 5 ~ 10 minutes.
Fever plaster
You can also use a commercially available "antipyretic patch" (or household ice pack) on your child's forehead to help cool down.
Ventilation and heat dissipation
Ventilation, pay attention to heat dissipation, wide clothes, avoid being wrapped in quilts. You can turn on the air conditioner in summer, and the room temperature should be controlled at around 27℃. Pay attention to regular window ventilation to make indoor air convection.
Ensure moisture
Drink plenty of water and eat a liquid diet, such as watermelon juice, to ensure that your body has enough energy and water.
Take off too many clothes.
If the baby's limbs, hands and feet are hot and sweating all over, it means that the heat needs to be dissipated, so you can wear less clothes.
Dietary nutrition The baby should stay in bed 1 week and drink plenty of warm water. Because of fever and oral herpes, the child has a bad appetite and is unwilling to eat. It is advisable to give your baby light, warm, delicious, digestible and soft liquid or semi-liquid food. The temperature of food should be slightly cooler, not too salty, so as to reduce the irritation to the surface of oral ulcer and avoid spicy. Intravenous rehydration should be given to children with obvious pain who refuse to eat.
Pay attention to the change of the condition. Because the enterovirus that causes hand, foot and mouth disease also has the characteristics of attacking the brain and heart, it can cause complications such as meningitis and myocarditis. Therefore, parents should closely observe the changes in their children's condition. When they find that the child has a high fever, severe headache, vomiting, pale face, crying or drowsiness, they should seek medical treatment in time.
4 How to judge whether the patients with hand, foot and mouth disease are getting better? According to clinical observation, parents are advised to judge whether children with hand, foot and mouth disease are getting better according to the following six points:
1. Herpes or oral ulcers subside. Herpes of hand, foot and mouth disease will grow on the mouth, hands and legs. Generally speaking, the herpes on hands and feet will subside faster, but the herpes in the mouth will be relatively slow. If parents find that the herpes in the baby's mouth has also subsided, it means that the condition will improve soon.
2. The rash disappeared. Some patients with hands, feet, buttocks, arms and legs may not have a fever. Only the hands, feet, buttocks, arms and legs appear maculopapules, and then become herpes. There may be inflammatory swelling around herpes, and there is less liquid in the blister. More common in the hands and feet, more common in the back of the palm. The number of rashes varies from a few to dozens. If the condition improves quickly, these rashes will disappear by themselves, leaving no trace and no pigmentation after fading.
3. Patients with high fever after the recovery of hand, foot and mouth disease will have different degrees of fever, and many patients will have repeated fever. Therefore, reducing fever has mostly become a major focus of hand, foot and mouth disease nursing. If the patient begins to have fever, the fever has gone down now, and there will be no more fever, which means that the patient has begun to pack up and his condition is close to recovery.
4. Improved appetite. Patients with hand, foot and mouth disease suffer from oral pain and anorexia due to herpes or oral ulcer. If the herpes or oral ulcer in their mouth improves, the appetite of patients will also improve, so we can also see whether the hand, foot and mouth disease will improve soon according to whether the appetite of patients improves.
5. Good mental state Hand, foot and mouth disease is a relatively uncomfortable disease, which not only causes body rash and oral discomfort, but also causes many complications such as fever, diarrhea and vomiting. Therefore, most patients with hand, foot and mouth disease are in poor mental state, which is characterized by depression, loss of appetite, inactivity and unwillingness to talk. If the above phenomenon improves, they become fond of talking and activities, which shows that their condition will improve soon.
6. Severe rehabilitation is an indicator for patients with mild hand, foot and mouth disease to recover quickly. If the patient's condition is serious during hand, foot and mouth disease, and problems such as meningitis, encephalitis, encephalomyelitis, pulmonary edema, headache, vomiting, dyspnea, convulsion, increased or decreased heart rate, etc. occur, it will take a relatively long time for the patient to recover. Generally, the recovery of the above diseases is used as an indicator to judge whether the patient recovers quickly.