Camp RN assessment/mgmt : Child hit in eye by rock

Neveranurseagain, RN · Oct 22, 2009

When in doubt, ship them out is my protocol. My kid--I might wait and see but these aren't my kids. Call the parent and involve them in the decision as to send them to ER/MD.

Penguin67 · Oct 22, 2009

Can you tell us what the result was? If it's just a bruise and vision is ok, I'd just watch., But if swelling is a problem and obvious damage has been done to the actual eye structure and vision is impaired, take them in. We had a kid who tore a tear duct at around 10pm, and we took him to a hosptial (we only knew he had an eye injury and there were some other problems that I cannot recall, as this was 15 years ago). The hospital immediately referred him to the eye hospital downtown where the torn duct was diagnosed.

sassasha · Oct 22, 2009

This happened to another nurse at a prior session and I heard about it. I hear child was in severe pain and vision was blurred. The child turned out to have a corneal laceration (deep corneal abrasion) to the stroma and severe iritis. Parents weren't notified and RN/camp chose to wait and watch. When child got home 6d later parents noted pupils were very different sizes and injured eye did not respond to light and got her diagnosed. I hear the girl's vision is now blurred due to scarring and iritis lasted several weeks & most of pupil function returned. I of course know that I would follow the "if in doubt ship 'em out" motto with any eye injury especially with a high-velocity object.

mamamerlee, LPN · Oct 22, 2009

Any blow to the eye which involves the orbit itself or direct injury to the eyelids goes to the nearest ER. There is no way you can diagnose or treat an eye injury at a camp. Wasn't there an MD available? This child must have been in some pain. How was the injury treated?

Without an MD making an assessment, the kid goes to the ER. Immediately.

sassasha · Oct 22, 2009

An outside doctor was available by phone for consult, but not contacted. Eye was flushed copiously with saline (without anesthetic drops) and then natural tears eye drops were put in every three hours during the day the remaining five days of the camper's stay. Child c/o photophobia, feeling of something in eye, lid swelling, eye pain for several days. Yes, I hear child was in serious pain night of injury. Hearing about this situation broke my heart.

mamamerlee, LPN · Oct 23, 2009

I hope that nurse has excellent malpractice insurance.

sassasha · Oct 23, 2009

I couldn't agree more about the malpractice insurance. I will always be haunted by that story. There's something about how vulnerable that child was! Thanks for the input everyone!

carachel2 · Dec 18, 2009

We had a girl who had a glo-stick burst and the chemical inside the stick got in her eye. Find a procedure manual for that one! After copious irrigation x 30 minutes, the girl still complained of pain and photophobia so we took her straight to the ER. I simply cannot imagine trying to treat an eye injury symptomatically at camp.