First time camp nurse here! I have a camper who came to me with dry ice burns from two days ago. A cabin-mate had received cupcakes packed in dry ice and this camper put some dry ice on left wrist and hand. The burn on her wrist is about 1.5cm long, reddened, skin intact, painful. The burn on her hand is about 1cm rounded, reddened edges, white/yellow in middle with a tiny intact blister, and numb. She had been pushing on the dry ice on top of her hand, trying to make it melt faster.
My standing orders for burns are "rinse with cool water, apply cool compresses then topical antibiotic ointment and dsd. administer tylenol for pain. seek medical attention if signs of infection develop." I cleansed areas, applied antiobiotic ointment, dsd.
My question is whether I should call the on-call physician. There are no signs of infection but I am concerned about the burn on her hand. Also would you telephone the parents? She's an older camper and has now learned her lesson but I don't want her to head home with a scar and have upset parents.
Thanks in advance for any help anyone can give me! :-)
Jul 25, '13
Hand burns fall under 'critical burns' especially with numbness and a blister. Call the on call MD. This may involve a trip to ED/urgent care for formal evaluation of a chemical/thermal burn.
As a parent I would expect at least a call about such an injury.
ETA since this is an older child I'd say have them nearby so mom/dad can speak to their child.
Now she knows why dry ice is classified as a hazardous material and requires dangerous goods declaration for shipping. I'm surprised the camp permitted the camper to have the package in the living quarters. Perhaps as camp nurse you can work with camp admin for developing a policy regarding safe handling of dry ice/haz. Mat.
Last edit by JustBeachyNurse on Jul 25, '13