EYE INJURY

Inclusion Criteria:  Patients with blunt or penetrating trauma to the eye or patients with 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

  1. Assess and support ABCs.
  2. Initiate SPINAL MOTION RESTRICTION, as needed.  If spinal injury is not suspected, place the patient in a position of comfort.  If there is evidence of shock, place the patient supine with the feet elevated and closely monitor airway status.  Treat shock according to the SHOCK Guidelines.
  3. Conditions:
    1. If eye avulsion, ruptured globe, or impaled object:
      1. Do not administer anesthetic drops.
      2. Do not attempt to remove the object.
        1. If the object large and protruding from the eye, attempt to stabilize it.
      3. Carefully cover the affected eye (if possible) to protect it from further damage.
      4. Cover the other eye to decrease eye movement.
    2. If a corneal burn or corneal abrasion has occurred – Remove contact lenses, if possible:
      1. May administer 1-2 drops ophthalmological anesthetic agent to affected eye(s): may repeat every 5 minutes to a maximum total of three doses, as needed for pain control.
      2. Instruct the patient not to rub the eyes.
    3. For eyes injured by chemical exposure, tear gas, pepper spray or mace – Remove contact lenses, if possible:
      1. May administer 1-2 drops ophthalmological anesthetic agent to affected eye(s): may repeat every 5 minutes to a maximum total of three doses, as needed for pain control.
      2. Irrigate with Normal Saline en route.
      3. NOTE: Persistent symptoms 15 to 30 minutes or more post-exposure to crowd control agents (e.g. tear gas, pepper spray or mace) require ophthalmological evaluation in a medical facility, even if this is the patient’s only injury.
  1. Transport the patient with the head slightly elevated and BOTH eyes closed or loosely patched (unless specific treatment indicates otherwise).

Advanced Level

  1. Consider establishing IV/IO access at a TKO rate or use a saline lock.
  2. If pain persists, treat according to the PAIN MANAGEMENT Guidelines,
  3. For additional patient care considerations not covered under standing orders, contact BioTel.