Now let's cover the topic of eye injuries, of which there can be a couple of main types.
One is an object embedded in the eye. The other is a chemical in the eye. In this case,
we're going to be first addressing the object in the eye. In this case we know that the
worker was by a grinding wheel, and potentially one of the brushes may have flown off the
wheel and embedded in their eye. They're in a great deal of pain. We've gone ahead and
assessed for scene safety, our gloves are on, and also the patient is not suffering
from airway, breathing, or circulation problems at this time, so they're remaining fairly
stable. We guided them to a place where they could be sat down carefully and now treated,
and here's what we're going to do. We find a cup. It's important to understand that we
want to actually get something that goes over the wounded eye so that we don't put any pressure
on the object that's embedded in the eye. The second thing too is, if you have a medical
grade cup, that's fine, but you could also use a Dixie cup or a drinking cup, a styrofoam
cup, a coffee cup. It really doesn't matter. It doesn't have to be overly large, because
that's going to cause some problems in trying to bandage around it, so the smaller, the
better. But we do want it to be at least deep enough that it keeps the pressure off from
that eye. The second point to make is that we want to bandage both eyes shut because
eyes tend to move together. So if we leave one eye unbandaged so the person can see,
when they move that eye they will also be moving the affected eye, and we don't want
to cause further harm. The third point, and lastly, we can have the patient assist us,
when we're having them hold the cup or hold things in place while we bandage. So here
we are. I'm just going to go ahead and put this cup over your affected eye, ma'am. Go
ahead and take your hand away. Now can you hold that cup in place? Now the second thing
I'm going to do-- and be sure to talk to your patient. They're kind of blind at this point,
so you want to be really communicating with them, instead of making them guess what they're
feeling, like, "Now I'm putting a cup on your eye, and now I'm going to throw a bandage
on your eye." Explain what you're going to do before you do it, so we don't shock them.
And then the other thing to remember too is, once this is all bandaged, they're blind.
We're going to have to lead them as if they are blind, making sure to remind them where
to step, how to step, so they don't fall down. And ideally we're going to transport this
patient via EMS, because there's things that we can do en route that might not be able
to be done in a private car. But if the EMS is not an option, private car may work as
long as the patient is stable and doesn't have any other injuries that would stop them
from being transported. So I took another 4x4 gauze. If you had an actual eye bandage,
you could use that, certainly, but a 4x4 gauze is not a problem either. Ma'am, I'm going
to put this over your non-affected eye, and you can hold that in place, and I'm just going
to wrap a gauze around both of them. Go ahead and let go of the cup side. I'm going to put
a bandage around. Let me know if that hurts at all, okay? Not the eye that's hurt, but
I mean, as I'm wrapping, any new pain. Now I'm going to go ahead and wrap around this.
You can let go. And I'm just going to continue here. I know that's over your nose, but I'll
move that in just a second, okay? I'm going to continue to bandage around, and probably
just a good couple times. You just want to make sure that the cup is not going to slip.
And then once you come back around to the other side, we tuck the excess in underneath
the bandage, as long as it's not putting too much pressure. Or you could always tape it
in place. Is that fairly comfortable, ma'am? I'm going to go ahead and lift this over your
nose so you can breathe okay. Now the patient is packaged and ready to go. Now we're going
to be doing our secondary survey, which is doing a double-check. This is a pretty distracting
injury, so it could take our eyes, our eyes as rescuers, off from other things that might
be happening. Maybe she fell after she got the injury in the eye and hit her head. So
we're always going to be assessing for level of consciousness, airway, breathing, circulation,
signs of shock, and treating accordingly, as we get this person into definitive care
and back on track. And now let's take a look at the other type of eye injury, which is
chemical burns. Whether a dry chemical or a liquid chemical, it can cause a great amount
of damage to this eye and the mucous membrane of the eye in a relatively short amount of
time. So getting the person to a position where we can actually start to dilute the
chemical as soon as possible is essential. Now we would like to use a balanced solution
as far as pH goes, but if you only have the tap water out of a sink, or you have bottled
water, drinking water, anything is going to be better than nothing. If it's a dry chemical,
we're going to brush as much of the excess off as we can before we begin to dilute it
and flush the eye. If it's a liquid, we're just going to begin flushing. A key point
here: If it's one affected eye, we want to go from the inside of the eye and rinse to
the outside. We don't want to cross-contaminate eyeballs. We don't want to flush from outside
in, as it can then run over the bridge of the nose into the non-affected eye. Now we've
got chemical exposure to both eyes. Remember that we're going to flush for no less than
20 minutes to dilute and to bring the solution into a position where it's not causing damage.
We're going to transport this person to an emergency room as soon as possible, and we're
going to watch for other life-threatening issues. Remember, the chemical that went in
the eye could have also gotten into the mouth, nose, or airway, so we don't want to take
for granted that this is an isolated injury. So we're going to continue to assess our patient
from head to toe, looking for life-threatening situations like airway, breathing, circulation,
or shock symptoms, and treat accordingly, and then continue to flush those eyeballs
out so that we can get the chemical out and stop the burning from happening.