RTS - Central Nervous System

What are the symptoms of motion sickness using the SOCRATES framework?

Inner ear, sudden onset with motion, dizziness/nausea/vomiting, no radiation, sweating/headaches/impaired digestion, occurs during travel, worsened by reading/screens, relieved by fresh air/horizon, mild to severe"

What are the first-line treatments for motion sickness?

Hyoscine hydrobromide (Scopolamine, take 30 min before travel), antihistamines (cinnarizine, promethazine), ginger supplements"

What are the red flags for motion sickness requiring referral?

Persistent vomiting/dehydration, symptoms lasting after motion stops, dizziness with hearing loss"

What self-care measures help manage motion sickness?

Sit in front seat of car or middle of boat, focus on horizon, avoid large meals before travel, use acupressure bands, avoid alcohol"

What are the criteria for diagnosing insomnia?

Difficulty falling or staying asleep for over 30 minutes, impacting daytime function, can be acute (<3 months) or chronic (>3 months), primary or secondary"

What are the symptoms of insomnia using SOCRATES?

No physical site, gradual onset, difficulty sleeping >30 min, no radiation, daytime fatigue/irritability/poor concentration, worsened by stress/depression/shift work, mild to severe"

What are the OTC treatments for insomnia?

Antihistamines (diphenhydramine, promethazine), herbal remedies (valerian root, passionflower)"

What are the red flags for insomnia requiring referral?

Suspected sleep apnoea, severe anxiety/depression, long-term medication-induced insomnia, unexplained weight loss"

What self-care strategies are recommended for insomnia?

Maintain sleep hygiene (18°C room, regular sleep schedule, limit screen time 2-3 hours before bed), avoid caffeine/alcohol, use relaxation techniques, exercise, keep a sleep diary"

What are the symptoms of jet lag using SOCRATES?

Brain (circadian rhythm), after long-haul flights, fatigue/disorientation/difficulty sleeping, no radiation, mood changes/digestive issues/headaches, peaks 1-2 days after travel, worsened by poor sleep hygiene, mild to moderate"

What treatments are used for jet lag?

Melatonin (prescription), address insomnia with antihistamines or herbal remedies if needed"

What are the red flags for jet lag requiring referral?

Severe fatigue affecting daily function, symptoms persisting over 2 weeks, higher risk in older adults"

What self-care measures help manage jet lag?

Adjust sleep schedule before travel, expose to sunlight in new time zone, avoid excessive alcohol/caffeine, stay hydrated, eat light meals"

What are the symptoms of snoring using SOCRATES?

Upper airway (throat), gradual onset worsening with age, loud breathing noises during sleep, no radiation, dry mouth/sore throat/morning headache, worse when sleeping on back, worsened by alcohol/obesity/nasal congestion, mild to severe"

What are the OTC treatments for snoring?

Nasal strips (Breathe Right), acupressure rings, mouthguards (Mandibular Advancement Devices), nasal sprays for congestion"

What are the red flags for snoring requiring referral?

Suspected sleep apnoea (gasping/choking/excessive daytime sleepiness), sudden onset of snoring"

What self-care measures help reduce snoring?

Sleep on side, lose weight if overweight, avoid alcohol before bed, keep nasal passages clear, maintain sleep hygiene, use supportive pillows"

What are the symptoms of obstructive sleep apnoea (OSA) using SOCRATES?

Upper airway (throat), gradual onset, repeated breathing interruptions, no radiation, loud snoring/choking/gasping/daytime sleepiness/poor concentration, occurs nightly, worsened by obesity/alcohol/sedatives, moderate to severe"

What treatments are used for obstructive sleep apnoea?

CPAP machine, Mandibular Advancement Devices, weight loss, lifestyle changes"

What are the red flags for obstructive sleep apnoea requiring referral?

Severe daytime sleepiness affecting driving, high blood pressure or heart problems, breathing pauses over 10 seconds during sleep"

What self-care measures are recommended for obstructive sleep apnoea?

Sleep on side, lose weight if overweight, avoid alcohol/sedatives, use CPAP if diagnosed"

What other factors can contribute to CNS-related issues like insomnia or sleep apnoea?

Caffeine/stimulants, medications (decongestants, corticosteroids, beta blockers, antidepressants), medication interactions"