Procedure
Eye Irrigation
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Eye Irrigation
Indications
Chemical Eye Injury
Equipment
pH paper
Eye Irrigation fluid (Use best option that is immediately available)
Preferred irrigants (liter bags - may require up to 10 liters)
Normal Saline
or
Lactated Ringers
Alternatives if preferred agents unavailable
Sterile water
Eyewash station or equivalent clean water supply
Irrigation additives
Consider placing 10-15 cc of 1%
Lidocaine
in the saline bag to maintain adequate topical
Anesthesia
during 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
Technique
Pre-treat with
Topical Eye Anesthetic
(if available)
Do not delay irrigation for contact removal
Contacts can be removed after irrigation
Immediate copious irrigation for at least 30 minutes
After 30 minutes of irrigation, close eye for 5 minutes
Test
Eye pH
(goal is neutral pH 7.0 to 7.3)
Continue Eye Irrigation until
Eye pH
7.0 to 7.3 (may require up to 10 liters of irrigant)
If pH paper not available, irrigate for minimum of 2 liters irrigant over 30 minutes
Adjunctive measures
Consider sweeping medial and lateral canthus for crystallized chemical
Use moist swab to remove debris from
Conjunctiva
l fornices
May be speed neutralization of pH
Precautions
Never use acid or base to neutralize
Chemical Burn
Efficacy
Eye Irrigation reduces risk of serious
Eye Injury
and dramatically reduces healing times
Ikeda (2006) Ophthalmologica 220:225-8 [PubMed]
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