Where There Is No Doctor 2011 33
The pulse gets much faster with exercise and when a person is nervous,
frightened, or has a fever. As a general rule, the pulse increases 20 beats per minute
for each degree (°C) rise in fever.
When a person is very ill, take the pulse often and write it down along with the
temperature and rate of breathing.
It is important to notice changes in the pulse rate. For example:
• A weak, rapid pulse can mean a state of shock (see p. 77).
• A very rapid, very slow, or irregular pulse could mean heart trouble
(see p. 325).
• A relatively slow pulse in a person with a high fever may be a sign of typhoid
(see p. 188).
EYES
Look at the color of the white part of the eyes. Is it normal, red (p. 219), or yellow?
Also note any changes in the sick person’s vision.
Have the person slowly move her eyes up and down and from side to side.
Jerking or uneven movement may be a sign of brain damage.
Pay attention to the size and color of the pupils (the black ‘window’ in the center
of the eye). If they are very large, it can mean a state of shock (see p. 77). If they are
very large, or very small, it can mean poison or the effect of certain drugs. If there is
a white glow, it can mean cataracts (see p. 225) or cancer.
Look at both eyes and note any difference between the two, especially in the size
of the pupils:
A big difference in the size of the pupils is almost always a medical emergency.
• If the eye with the larger pupil hurts so badly it causes vomiting, the person
probably has GLAUCOMA (see p. 222).
• If the eye with the smaller pupil hurts a great deal, the person may have
IRITIS, a very serious problem (see p. 221).
• Difference in the size of the pupils of an unconscious person or a person who
has had a recent head injury may mean brain damage. It may also mean
STROKE (see p. 327).
Always compare the pupils of a person who is unconscious or has had a
head injury.