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Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined and in italics . If you don’t start to get better within the suggested time frame, see a health care provider. If at any time you think your minor illness is getting worse, see a health care provider.
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Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Mar 26, 2015

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Page 1: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Time Frame for Self-care Measures

Each symptom evaluation chart has a suggested time frame for using self-care measures.

The time frame is underlined and in italics.

If you don’t start to get better within the suggested time frame, see a health care provider.

If at any time you think your minor illness is getting worse, see a health care provider. 

Page 2: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

TROOP MEDICAL CLINIC (TMC) SELF-CARE PROGRAMTREATMENT OPTIONS FOR SYMPTOMS/CONDITIONS

I am aware that I am participating in a self-care program. I understand that to properly perform self-care and safely treat any symptom(s) of conditions(s) that I may have during training I must follow the symptom evaluation charts. I also understand that I am responsible for carefully following the directions for use of any medication received through this program. I verify that I have read the self-care decision guide and the recommendations provided therein. I also verify that I am requesting treatment options(s) voluntarily. I also agree that I will not share medication with anyone and that I will be the sole user.

What allergies, to include medications, do you have?_________________________________________

What medicines are you presently taking? ______________________________________________

Print Name Print SSN DateSignature Unit: Sex: M F

INSTRUCTIONS: After reading the Soldier Health Maintenance Manual and identifying the proper treatment option(s), find the symptom(s)/condition(s) that you have on the list below. Circle it. Then follow the line across to find the treatment option(s) for your symptom(s)/condition(s). Circle the treatment you would like to receive. Request the identified treatment option(s) from the Consolidated Troop Medical Clinic Pharmacy.

Treatment requests will be limited to five items.NOTE: You can select Daytime OR Robo DM liquid but NOT

BOTH. You can select Daytime OR SudaGest, but NOT BOTH.

Green SheetSample

Page 3: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

SYMPTOM/CONDITION: TREATMENT OPTION

Acne . . . . . . . . . . . . . . . . . . . . . . . . . . . . Medication (Benzoyl Peroxide)Allergies & Hay Fever . . . . . . . . . . . . . . . . . . . .SudaGest Decongestant

(Pseudoephedrine)*Athletes Foot . . . . . . . . . . . . . . . . Miconazole Nitrate Antifungal CreamBlisters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mole Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Band-Aid . . . . . . . . . . . . . . . . . . . . . . . . . . Bacitracin Antibiotic Ointment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Baby Powder (Talc)Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Genasoft (Ducosate)Cough with congestion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Daytime*Cough (dry) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Robo DM liquid*Cut or Scrape . . . . . . . . . . . . . . . . . . . . . Bacitracin Antibiotic Ointment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Band-AidDiarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . Anti-Diarrheal (Loperamide)Earache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ibuprofen TabletsHeadache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ibuprofen TabletsHeat Rash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Baby Powder (Talc)Insect Bite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Calamine Lotion . . . . . . . . . . . . . . . . . . . . . . Cortaid Cream (Hydrocortisone)Jock Itch . . . . . . . . . . . . . . . . . . . Miconazole Nitrate Antifungal Cream . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Baby Powder (Talc)Muscle Pain & Inflammation . . . . . . . . . . . . . . . . . . . .Ibuprofen TabletsNasal or Sinus Congestion (without cough) . . . . . . . . . . . . . SudaGest

Decongestant (Pseudoephedrine)*Poison Ivy/Oak/Sumac . . . . . . . . . . . . Cortaid Cream (Hydrocortisone)PreMenstrual Syndrome . . . . . . . . . . . . . . . . . . . . . . . Ibuprofen TabletsRingworm . . . . . . . . . . . . . . . . . . Miconazole Nitrate Antifungal CreamRunny Nose or sneezing . . . . . . . . . . . . . . . . . SudaGest Decongestant

(Pseudoephedrine)Sore Throat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CepacolUpset Stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maalox Antacid PlusVaginitis . . . . . . . . . . . . . . . . . . . . . . . . . Gyne-Lotrimin (vaginal insert)

Page 4: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

YELLOW SHEETSelf-care Program Evaluation

(Program Participant—Soldier)InstructionsPlease complete Part 1 and Part 2.

Your responses are very important to the Self-care Program. This information is completely confidential and will only be used to improve the program. Please write any additional comments at the bottom of the page. Return the completed form to the proper pick-up location. Thank you.

Part 1Date: ___/___/___Installation: ______________________Unit: ______________________________MOS: ______________

Please circle one response for each of the following: Age: 18 – 19 – 20 – 21 – 22 – 23 – 24 – 25 – Over 25 Sex: M F

Highest education level completed: GED – High school – Some college – College graduate

Page 5: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Yellow Sheet: Part 2 Please circle one response for each of the following questions. If

not sure, leave that question blank.1.  I used the Self-care manual at least once to take care of myself.

Yes No 

2.  I made at least one clinic visit for Self-care using the Green Sheet.Yes No

3.   I made at least one clinic visit for regular Sick call. Yes No

4.   The Self-care Program helped me to avoid missing training time at least once. Yes No

5.  I would feel comfortable following the Self-care steps in the manual if I needed to. Yes No 

6.  The Self-care Program is a valuable benefit for my own health. Yes No

7.  The Self-care training and manual taught me how to take better care of myself. Yes No

8.  When I can, I prefer to use the Self-care Program instead of regular Sick call. Yes No

9. The training and manual helped me decide whether to use Self-care or regular Sick call . Yes No

  10.  The Self-care Program should be available to all soldiers

Yes No

Page 6: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Presentation Self-care class presentation

Page 7: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Mini Teach-Back Objective:

– To practice doing the self-care class in front of a group in a non-threatening situation.

A teach-back is a short practice session that helps you to become familiar with presenting self-care class materials.

Highlight three main points about self-care.– Describe/define self-care process– Use manual and symptom evaluation

charts exercises.– Select appropriate OTC items from

green sheet from a scenario.

Page 8: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Important Points to Remember

Soldiers cannot share OTC medications with their buddies.

OTCs can mask serious symptoms.

Know the difference between non-emergency and emergency symptoms.

The five requested OTCs on the green sheet must be related to the chief medical complaint.

Page 9: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Tracking Mechanisms

Submit a class roster or attendance sheet to the Self-care Program Coordinator or to the pharmacy.

Self-care stickers should be placed on ID cards of soldiers who complete the class.

Green sheets are only to be used by soldiers who have completed the self-care class.

Page 10: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Self-care Quiz

Page 11: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Administering the Quiz

Projection on to the screen/wall via an overhead projector.

Print quiz on both sides of paper indicating pre-test and post–test or have student indicate pre/post test.

Place on the back of the yellow sheet and use as a final assessment of knowledge and understanding of the self-care.

The terms OTC medications and self-care medications are used synonymously.

Page 12: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Questions?

Page 13: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Self-care Quiz

1. Self-care is taking care of your own health for treatment of minor health problems.a. True

b. False

2. I can get up to 5 self-care medications for minor health symptoms that I might have.

a. True

b. False

Page 14: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Self-care Quiz

3. Ibuprofen tablets are available through the Self-care Program.

a. Trueb. False

4. To use the Self-care Program, I have to fill out a “green sheet.”a. Trueb. False

5. If I answer “yes” to a question on a symptom evaluation chart, I must use sick call.a. True

b. False

Page 15: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Self-care Quiz

6. I can share medications from the Self-care Program with my battle buddies.

a. True

b. False

7. Information about over-the-counter (OTC) medications is located in the Soldier Health Maintenance Manual.

a. True

b. False

8. The pharmacist can answer questions that I may have about OTC medications.

a. Yes

b. No

Page 16: Time Frame for Self-care Measures Each symptom evaluation chart has a suggested time frame for using self-care measures. The time frame is underlined.

Self-care Quiz

9. If I have severe pain and vomiting, I should:

a. Get medical help right away.b. Use the Self-care Program.

10. If I have a symptom that is not in the book, I should use:a. The Self-care Program.b. Sick call.