Eye injuries aren’t very nice… okay, they are one of my pet-hates at work, treating eye injuries. I’m sure they’re not much fun for the patient with the eye injury either. However, it is good to know that the cornea, which is basically the safety cover over the lens, is the most resilient and has the most self rejuvenating and healing properties of cells in virtually the entire body. This means that, in most cases, where a person has been splashed with acid, or experienced some eye trauma and are no longer able to see, will eventually re-gain their sight. In many cases of hydrochloric acid burns (quite common in some industries, such as pool cleaning) patients are able to treat their eye injuries and gain full sight within 24 hours.
Types of Eye Injuries
In eye trauma, we control haemorrhage around the yee or eyelids with direct pressure, but make sure that we do not place any pressure on the eyebal itself.
If caustic powder is present, you must remove this prior to irrigating the area. Then irrigate the area with as much water as possible (preferably saline if possible). We do this for about 20 minutes, but the longer you can stand it the better generally. Continue irrigating if in doubt. Make sure you retract the lids to ensure thorough flushing throughout. Contact lenses should be removed if they are still insitu.
Oleoresin Capsicum spray is one of the more common defensive techniques that Law Enforcement utilize to protect themselves from violent persons and as a non-lethal means of breaking up a altercation. Paramedics treat patients who have been exposed to oleoresin capsicum spray by providing a acid buffer such as baby shampoo. It is important to allow the patient to wash their own eyes so that you do not become contaminated with oleoresin capsicum spray.
Eye Injury Paramedic Treatment
Protect the eye
Try not to let the patient rub their eyes – this only makes it more inflamed and ultimately hurts them more. You may apply an eyepad lightly taped in position. There is no benefit from covering the good eye and this will often just make the patient more agitated and may lead to motion sickness and vomiting which is very bad in eye injuries because it results in an increase in intra-occular pressure (pressure on the eyeball), which is bad.
Provide an antiemetic
Because we do not want these patients to vomit, it is important to administer an antiemetic. Often, while having one eye covered patients may become disorientated and develop motion sickness. Therefore, antiemetics should be aimed at treating motion sickness, such as promethazine or ondansetron