This condition is an infestation of the skin by
body lice. The louse inhabits the seams of clothing
and feeds on the skin, which results in severe
itching and produces small red lesions occurring
from the bites. The most common sites of lesions
are the buttocks, shoulders, and abdomen. The
body louse is an important vector in transmitting
typhus, trench fever, and relapsing fever.
This condition is characterized by infestation
of the anogenital regions with crab lice. This
infestation is the result of direct contact with the
lice through sexual activity, toilet seats, clothing,
or bedding. The louse is comparatively large but
not eaily seen, and itching is almost always
present. The patient may note the presence of
small specks on the sheets upon arising.
TREATMENTThe treatment for all pedi-
culosis infestations consists of applying ointments
containing benzoate and benzocaine and main-
taining proper hygiene habits. Use caution when
treating around the eyes. Two applications of
medication are usually sufficient. Check contacts.
Use calamine lotion to control itching, and
launder all bedding and clothing.
DISORDERS OF THE
Levels of Consciousness
Abnormal levels of consciousness may be
associated with decreased or increased
neurological activity, such as stupor, coma,
delirium, or violent behavior. There may be
partial to complete mental clouding or loss of
Frequent causes are cerebro-
vascular accident (CVA), drugs, poisons, and
The two major categories of loss of conscious-
ness are stupor and coma. Stupor ranges from
partial to almost complete loss of consciousness.
Coma is complete unconsciousness from which
the patient cannot be roused.
In any case of consciousness disorder, it is
important to obtain a complete history from those
who know the patient or who may have witnessed
the incident causing it. Perform a thorough
physical examination, including checking the
pupils for size and reaction to light. The key points
to look for when a neurological disorder is
suspected are abnormal vital signs, signs of
injury, or alcohol or drug intoxication. Also look
for discolorations of the skin in the area behind
the ears that may indicate a skull fracture.
TREATMENTThe immediate objective of
treatment is to maintain life until a specific
diagnosis is made. Avoid sedatives and stimulants,
and keep semiconscious patients NPO. Catheter-
ize unconscious patients and test the urine for
sugar, acetone, and albumin. Treat symptomati-
Syncope and Vertigo
Syncope is a temporary loss of consciousness
as in fainting. Vertigo is an illusionary sensation
SYMPTOMSThe patient is usually in an
upright position when an attack occurs. He or she
may experience mot or weakness, epigastric
distress, perspiration, restlessness, yawning and
sighing, bradycardia, and a fall in blood pressure.
TREATMENTPlace the patient in the
and administer spirits of
Headaches are so common that most everyone
has some experience with them at one time or
another. They may be caused by tension, tumors,
trauma, or any number of other causes. The
following are the more common types of
l TensionThese headaches are caused by
spasm or contraction of diseased muscles or
adjacent structures, or they may be associated
wit h fatigue or emotional stress. The muscles
attached to the occiput are the most frequently
involved. This is the most common type of
SYMPTOMSThe common complaints are
a feeling of pressure or tightness or a bandlike
constriction and pain.
TREATMENTGeneral measures consist of
analgesics, rest, relaxation, massage, and heat
applied to the involved musculature.