II. Indications
III. Contraindications
IV. Equipment
- pH paper
- Eye Irrigation fluid (Use best option that is immediately available)
- Eyewash station (allows for immediate copious, continuous irrigation)
- Preferred irrigants (liter bags - may require up to 10 liters)
- Alternatives if preferred agents unavailable
- Sterile water
- Clean water supply (water tap with potable, drinkable water supply)
- Irrigation additives
- Consider placing 10-15 cc of 1% Lidocaine in a 1 L saline bag to maintain adequate topical Anesthesia during irrigation
- Consider warmed fluids (not hot!) for irrigation
- Irrigation device (any clean device that can direct irrigant flow to eye)
- Morgan Medi-Flow lens
- Intravenous tubing
- Nasal canula (attached to IV tubing)
- Can straddle the Nasal Bridge such that each nasal prong can be directed toward each eye
V. Technique: Chemical Eye Injury
- Pre-treat with Topical Eye Anesthetic (if available)
- Do not delay irrigation for contact removal if unable to promptly remove after Chemical Eye Injury
- Contacts can be removed after irrigation
- Immediate copious irrigation (for at least 30 minutes for significant Chemical Eye Injury)
- Adjunctive measures
- Retract the upper and lower Eyelids during irrigation to ensure irrigation of the fornices
- Consider sweeping medial and lateral canthus for crystallized chemical
- Use moist swab to remove debris from Conjunctival fornices
- May be speed neutralization of pH
VI. Precautions
- Never use acid or base to neutralize Chemical Burn
VII. Efficacy
- Eye Irrigation reduces risk of serious Eye Injury and dramatically reduces healing times
VIII. References
- Warrington (2022) Crit Dec Emerg Med 36(9): 16