A client comes to the emergency department reporting alkaline drain cleaner splashed into the eye. The conjunctiva of the affected eye is erythematous, and the client reports a burning sensation. What action is appropriate at this time?

Question

A client comes to the emergency department reporting alkaline drain cleaner splashed into the eye.  The conjunctiva of the affected eye is erythematous, and the client reports a burning sensation.  What action is appropriate at this time?

Quizplus · Accepted Answer

11ecbb05_ca90_cb16_b433_7ff40e69ed42_MD0009_00 Ocular chemical burns require emergency care to prevent permanent vision loss. Alkali burns (eg, ammonia, cement, lye-containing drain cleanser) are particularly dangerous as they will quickly penetrate deep into the eye, causing severe, irreversible damage. For all types of ocular chemical burns, copious eye irrigation with sterile saline or water should begin immediately to flush the chemical irritant out of the eye (Option C). Before transport to an emergency care facility, tap water can be used for eye irrigation. If transported by ambulance, emergency care personnel continue irrigation during transport with IV tubing or a Morgan lens. Irrigation is continued until the pH of the eye returns to normal (pH 6.5-7.5), which typically requires 30-60 minutes depending on the type of chemical. (Option A) Depending on the severity of the burn, anesthetic eye drops may be instilled prior to irrigation because ocular burns are very painful, but systemic analgesia is not a priority. (Option B) Care of ocular burns may include covering the eye with an eye patch and use of eye drops to prevent eye muscle spasms; however, eye irrigation should be performed first. (Option D) The Snellen eye chart is commonly used to assess visual acuity. However, eye irrigation is essential and should not be delayed. Educational objective: Ocular chemical burns require immediate, copious irrigation with sterile saline or water to flush the chemical irritant out of the eye. Irrigation is continued until the pH of the eye returns to normal, which typically takes 30-60 minutes.

A Client Comes to the Emergency Department Reporting Alkaline Drain