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URTI SymptomaticOutpatient Self-Care*

*Source: Medscape

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Nasal and sinus symptomrelief

Warm moist air: Turn on hot shower water, close the bathroom

door, sit down, and inhale the steam. Take longsteam showers.

Use a vaporizer to increase humidity in rooms.The water must be changed daily to preventmicrobial growth, especially with heatedvaporizers.

Pour boiled water into a shallow pan or bowlplaced in a stable location (eg, middle of akitchen counter). Patients can drape a cloth overtheir head and lean over the bowl to inhale thesteam.

Sipping hot water or warm drinks may be moresoothing to the nasal passages than ice cold

drinks. Avoid extremel cool and dr air.

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Nasal and sinus symptomrelief

Nasal saline: A homemade normal saline solution can

be prepared by placing a fourth of a

teaspoon of table salt in 8 oz. of water. A bulb syringe, dropper, clean pump spray

bottle, or squeeze bottle can be used toinstill the saline into each nostril while theperson inhales and then expels the saline.

Saline is safe to use as needed.

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Nasal and sinus symptomrelief

Warm facial packs: These may provide comfort, relieve

congestion, and promote drainage in

cases of rhinosinusitis. A warm folded washcloth or hot-water

bottle (filled with hot water from a tap)may be applied directly to the face andcheek for 5-10 minutes.

Facial packs may be repeated 3-4 times aday as needed.

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Nasal and sinus symptomrelief

Bulb suction: For infants, a bulb syringe can be used to

gently suction the nostrils before feeding toease nasal breathing.

Parents should clean the bulb after each usewith hot soapy water followed by a rinse. Drain the bulb and allow it to dry before

reuse.

Irritant avoidance: Patients should avoid nasal irritants, such as

cigarette smoke and indoor and outdoor airpollutants.

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Cough relief Reduce irritating stimuli (eg, cold, dry air;indoor or outdoor air pollutants) that mayprovoke coughing.An upright or semiupright posture, suchas sleeping with the head and shouldersraised, may decrease cough related topharyngeal secretions.

A 2007 study showed that honey wassuperior to dextromethorphan inreducing cough symptoms and improvingsleep in children with URI.

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Sleep Sleeping with the head and shoulders slightlyelevated may promote sinus and nasal drainage.Many symptoms worsen at night because airwayclearance mechanics are relatively ineffective inthe prone position.Under normal circumstances, the 2 naresalternate between being open or closedthroughout the day. Cycles last approximately 45-90 minutes per nares.When the person is lying recumbent on one side,the nares closest to the pillow or surface tends tobecome congested while the higher nostril isdecongested.During nasal congestion associated with URI,alternating positions or lying with the shouldersand head propped up may increase comfort.

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DietFluid intake: Increased fluids are warranted to replaceinsensible losses and reduced oral intake.

Probiotics: Antibiotics alter the gastrointestinal flora, andsome foods may not be as digestible for days or weeks

after antibiotics are used. Consumption of yogurtcontaining active cultures has been advocated as anaid to restoring normal flora after antibiotic therapy. Ameta-analysis suggests that probiotics may preventantibiotic-associated diarrhea; Saccharomyces boulardii and lactobacilli may be particularly useful in

this situation.[34]

Alcohol intake: Alcohol may cause swelling of the nasaland paranasal sinus mucosae.

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ActivityRest: Patients with the common cold may consider returning to theirusual physical activity, including aerobic activity, if their symptomsare limited to the nose and throat. However, if cough, fever, or othersystemic symptoms are present, rest is indicated. Rest is helpful forrecovery from an URI.

Contact sports: Patients with infectious mononucleosis should beinstructed to avoid contact sports for 6 weeks because of thepossibility of splenic rupture.

Voice rest: This is indicated for patients with laryngitis orlaryngotracheitis.

Air travel: Patients may experience increased discomfort from upperairway infection during air travel. As atmospheric pressure dropsduring takeoff, expansion of soft tissues may block the eustachiantubes and increase pressure sensations in the sinuses.

Swimming: Chlorine from pools may be irritating to inflamed nasal

membranes. Diving, especially at depth, may cause uncomfortablepressure and impair drainage of the paranasal sinuses.

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Traditional Folk RemediesSome include sipping hot water with a teaspoonof honey and fresh lime or lemon juice; however,the acids in fresh citrus may be irritating to sorethroat.

Honey has more demulcent qualities.

Honey should not be given to infants because oftheir inability to easily digest spores commonlycontained in honey.

A 2007 study showed that honey was superior todextromethorphan in reducing cough symptomsand improving sleep in children with URI.