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Discussion

Dr order for an ice pack?

Hi there! I'm a new CNA working in a traumatic brain injury unit of a rehab facility. The other night, we had a fellow try to get into bed on his own without asking for help, and he fell and hurt his knee and lower leg. 2 days later, his leg is swollen and very sore - poor guy. Anyway, the nurse brought him his pain meds and he asked for an ice pack. The nurse immediately said that we couldn't give him one and the doctor would have to order it (without offering to contact the doctor or offering any other methods of treatment).

Is that true at your facility? I thought it was a minor treatment, but maybe I'm wrong. I'm not trying to undermine the nurse, I'm just curious. Thanks!

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    Where I work, a doctor may order an ice pack, but an order is not required for us to apply one.

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    If his leg is still that painful after 2 days the MD should know and he probably needs an X-ray to r/o a broken bone. She should have got him an ice pack and then called the dr.

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    I work on a surgical care unit and we most definitely have to have an order for an ice pack. Many of our surgeons specifically do not want their patients to have ice packs to their incisions and we had a patient once who came in with a red and swollen leg and she was given an ice pack without a Dr. order. She developed gangrene and the surgeon was very upset and said that it directly contributed to her development of gangrene.

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    Yes, MD orders for ice packs, warming blankets, coolings blankets, etc in my facility. MD orders are not needed for cool/warm compresses however.

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    Yes, we have to have an order for heat or ice.

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    In clinics that I've run which are within industry ice packs are "first aid," and a doctor's order is not required.

    A traumatic brain injury unit of a rehab facility is an entirely different story and I'm surprised that a doctor was not consulted and asked, not as much for the relief of the ice pack but if he fell hard enough to hurt his knee it would seem that would bring about some sort of fall protocol within the unit. The knee should have been attended to and I agree with the above--if it is still swollen two days later, it should be checked.

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