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Eye Injury
Inclusion Criteria: Patients with blunt or penetrating trauma to the eye or who have chemical substances in the eye. Refer also to Trauma guidelines, as needed. Treatment for adult and pediatric patients under this guideline is identical.
Basic Level
- Assess and support ABCs.
- Initiate spinal movement restrictions, as needed. If medics do not suspect spinal injury, place the patient in a position of comfort. If evidence of shock, place the patient supine with the feet elevated and monitor airway closely. Treat shock according to the Shock guidelines.
- Conditions:
a. If eye avulsion, ruptured globe, or impaled object:
i.
Do not administer anesthetic drops.
ii. Do not attempt to remove the object.
(1)
If large and protruding from the eye, attempt to stabilize the object.
iii. Carefully cover the affected eye (if possible) to protect it from further damage.
iv.
Cover the other eye to decrease eye movement.
b. If a corneal burn or corneal abrasion has occurred:
i.
Administer 1-2 drops ophthalmological anesthetic agent to affected eye(s): may repeat every 5 minutes to a maximum of three doses as needed for pain control.
ii. Instruct the patient not to rub the eyes.
c. For eyes injured by chemical exposure, pepper spray or mace:
i.
Administer 1-2 drops ophthalmological anesthetic agent to affected eye(s): may repeat every 5 minutes to a maximum of three doses as needed for pain control..
ii. Irrigate with normal saline while en route.
- Transport patient with head slightly elevated and BOTH eyes closed or loosely patched (unless specific treatment indicated).
Advanced Level
- Consider establishing IV access at a TKO rate or use a saline lock.
- For additional patient care considerations not covered under standing orders, consult BioTel.
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