Emergency Treatment of Chemical Eye Injuries

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EMERGENCY TREATMENTGUIDE TO CHEMICAL EYE INJURIES
Act immediately – every second counts
Get others to bring things to help you
Treat before referring and transporting

Immediate action

  • Stop whatever you’re doing
  • Call other staff to help
  • Lie patient down
  • Open the eye
  • Squirt in lots of anaesthetic (xylocaine ampoule or anaesthetic eyedrops)
  • Irrigate the eye thoroughly with water
  • Pour irrigating fluid from jug, bottle or giving set
  • Get patient to open both eyes and look straight ahead or down
  • Pull back the eyelids. irrigate under eyelids with a syringe or giving set
  • If ringing for advice use a portable phone and keep irrigating

Ongoing treatment

  • Continue irrigation for 30 minutes before transporting
  • Repeat anaesthetic drops every 5 minutes
  • Instil cyclopentolate drops every 5 minutes if available
  • Continue irrigation while transporting
  • All chemical injuries require immediate ophthalmic review

Overcoming problems

  • Pain Keep using anaesthetic and cyclopentolate drops. Give three paracetamol tablets (1500 mg) and consider IV or IM pain relief
  • Panic Call for help. Be very firm with uncooperative adults
  • Eyelid closure Used towels, cotton buds, a bent paperclip, lid speculum or Desmarres retractor to keep eye open
  • Eye movements Get patients to fixate on an object or their own outstretched hand
  • Infants Ask parents to leave. Swaddle and ignore crying
  • Watery mess Ignore, you are saving a person’s site!

IRRIGATE      IRRIGATE      IRRIGATE

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