Ice, Ice Baby

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Hopefully Helpful School Nurse Tip: Believe it or not the topic of ice packs is one of the most talked about topics within The School Nurse Fb groups! My best advice is for you to have a consistent routine that works best with your school nurse office and your students. Let's explore some popular opinions on ice!

Can I have an ice pack?

It's important to remember that students will come to your office and request an ice pack for a variety of reasons. Some of these reasons require ice, some do not. As the school nurse, use the information gathered during your assessment to decide whether or not an ice pack is needed. Then start writing down these complaints in your "Common Complaints" journal. You think you'll remember, but you won't and you'll have this journal as a a great reminder!

Ice Protocol

Every school nurse's office should have protocols to follow for certain situations; even when and how to use ice packs. There might be exceptions to protocols at times, but remember to be consistent- this will help your students know what their options and expectations are when they come to your office.

Use of ice
Effects of ice: Decreases circulation, metabolic activity, and inflammation and numbs the skin.
Benefits of ice: Decreases pain, swelling, inflammation, and muscle spasm/cramping. Best used after exercise or after pain-producing activity.
Risks of ice: Prolonged use can cause frostbite.
Methods for applying cold therapy: Ice packs, ice bath/ice whirlpool, ice massage. (See “Options for applying ice.”)
When not to use ice
Immediately before physical activity
If area of icing is numb
When the pain or swelling involves a nerve (such as the ulnar nerve or “funny bone”)
If the athlete has sympathetic dysfunction (an abnormality of nerves that control blood flow and sweat gland activity)
If the athlete has vascular disease (such as poor circulation due to blood loss, blood vessel injury, compartment syndrome, vasculitis, blood clots, or Raynaud disease)
If there is skin compromise (such as an open wound; a wound that has not healed; skin that is stretched, blistered, burned, or thin)
If the athlete has cold hypersensitivity, including cold-induced urticaria (hives from cold)
How long to use ice
Two to 3 times per day (minimum); up to once per hour.
Duration varies with technique; usually 20 to 30 minutes per session. (See “Options for applying ice.”)
Ice may continue to be useful in treatment as long as there is pain, swelling, inflammation, or spasm. There is no need to switch to heat after 48 hours or alternate between ice and heat.

Resource: AAP Healthy Children

Ice Pack Options

There are a variety of ice pack options to fit the budget of any school nurse. What option is best for your office? Here are a few things to consider:

What age range are your students?
Are students allowed to only use ice packs in your office?
Can students take ice packs back to class with them?
Do you expect students to return ice packs?
Will your ice packs be single use only?
Will you or your student call/notify home every time they use an ice pack?
Can students who are "hot" request an ice pack to help them cool off?
Is eating the ice allowed?
Do you have the assessment skills & confidence to say "No" to the request for an ice pack?

Depending on how you answered these questions, will depend on what ice packs are best for your office. For my office, we prefer a countertop ice maker with single use ice packs. In fact THIS is the exact countertop ice maker we have. and it works great.

We make ice and add to gallon size bags. Then, we fill sandwich size bags about 1/2 full and keep those stocked in the freezer to use as needed & repeat the 'ice cyle' (see what I did there) as needed too!