3-9 TRAUMA-EYE INJURY

Perform Initial Trauma Care per protocol.

EMR - Emergency Medical Responder

1. Do not allow eye injury to distract you from the basics of trauma care.
2. If patient and time permit, examine the globe briefly for gross injury as the lid may be swollen tightly shut later.
3. TRAUMATIC INJURY:
   1. Penetrating:
      1. Do not remove any foreign body imbedded in the eye or orbit. Stabilize any large protruding foreign bodies.
      2. Cover both eyes if patient will tolerate.  Involuntary movement of the good eye will cause movement of the injured eye.
      3. Transport patient supine unless other injuries prohibit this from being done. (This is to minimize intraocular fluid from draining out of the eye.)
   2. Non-Penetrating:
      1. If fine foreign bodies are still present on the surface of the eye, gently irrigate with water or saline.
4. CHEMICAL BURNS:
   1. When possible determine type of chemical involved.  If uncertain if a chemical can be flushed with water, contact Medical Control.
   2. The eye should be irrigated with copious amounts of water or saline as soon as possible.  Irreversible damage can occur in only a few minutes.
   3. Eye irrigation can be initiated with a garden hose if available. DO NOT use a high-pressure hose or at a high force.
   4. If available, IV saline can be used to irrigate the patient’s eyes.
      1. Attach saline bag to nasal cannula tubing, rest the nasal cannula across the bridge of the patient’s nose, and allow fluid to run into the eyes.
      2. Warmed saline is preferred if available.
   5. Attempt to obtain name and a sample of the chemical, or ask that they be brought to the hospital as soon as possible.
5. CONTACT LENSES
   1. If possible, contact lenses should be removed from the eye; be sure to transport them to the hospital with the patient. If the lenses cannot be removed, notify the ED personnel as soon as possible.
   2. If the patient is conscious and alert, it is much safer and easier to have the patient remove their lenses.

EMT - Emergency Medical Technician  Perform/Confirm All Above Interventions

1. Initiate early transport
2. Consider ALS Intercept

AEMT – Advanced Emergency Medicine Tech   Perform/Confirm All Above Interventions

1. Consider ALS Intercept
2. Establish IV en route, if possible.
   1. Avoid sites distal to deformities or on injured extremities.

Intermediate - Perform/Confirm All Above Interventions

1. Contact MEDICAL CONTROL for consideration of:
   1. Administration of pain medications, if approved, utilize pain management protocol for doses and monitoring.

                          

Paramedic - Perform/Confirm All Above Interventions

1. If patient requires intubation, succinylcholine should be avoided as it may increase intraocular pressure.