EMT Standing Order:

• Routine Patient Care.
• Obtain visual history (e.g., use of corrective lenses, surgeries, use of protective equipment).
• Obtain visual acuity, if possible.
• Assist patient with the removal of contact lens, if applicable.
• Chemical irritants, including pepper spray, alkali, acid or other chemical exposure:
  • Flush with copious amounts of water, or 0.9% NaCl for a minimum of 20 minutes.
  • Consider contacting Oman Poison Control Center (OPCC) at (24560019) as soon as practical for consultation.
• Thermal burns to eyelids: patch both eyes with a cool saline compress.
• Impaled object: immobilize the object and patch both eyes. Do not apply pressure. Do not attempt to remove objects.
• Puncture wound: place a rigid protective device over both eyes (e.g., eye shield). Do not apply pressure.
• Foreign body: Minor foreign objects like dust or grit may be flushed with water or 0.9% NaCl. Patch both eyes.
• If the patient cannot close their eyelids, keep their eye moist with a sterile saline dressing.

PARAMEDIC Standing Order:

• Consider the use of normal saline for irrigation.
• Refer to Pain Management Protocol - Adult & Pediatric (41 Medical).
• Refer to the Nausea/Vomiting Protocol - Adult & Pediatric (47 Medical).

PEARLS:

• For chemical exposure to the eye position the patient with the affected eye downward so irrigation does not run into the unaffected eye.